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General NPI Number Information
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NPI Number | 1386522365
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Entity Type | Organization
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Legal Business Name | SUMMIT MIND AND WELLNESS
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 20 OAK LEAF DR
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City | COLCHESTER
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State | CT
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Zip | 06415-2820
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Country | US
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Telephone | 860-303-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 2389 MAIN ST STE 100
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYDNEY ROYER
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Credential | MSN, RN, PMHNP-BC
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Telephone | 860-303-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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