Healthcare Provider Details

I. General information

NPI: 1265373948
Provider Name (Legal Business Name): SELF CARE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 TAMARACK AVE STE 201
SOUTH WINDSOR CT
06074-5559
US

IV. Provider business mailing address

60 PAPER CHASE
SOUTH WINDSOR CT
06074-2260
US

V. Phone/Fax

Practice location:
  • Phone: 860-419-0708
  • Fax:
Mailing address:
  • Phone: 860-419-0708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIELA R. SELF
Title or Position: OWNER
Credential: DNP APRN PMHNP-C
Phone: 860-419-0708