MEDICARE: CONCUSSED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1235087065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCUSSED.

Provider Business Mailing Address
First Line	:	1000 BOSTON POST RD # 1041
Second Line	:
City	:	OLD SAYBROOK
State	:	CT
Zip	:	06475-2142
Country	:	US
Telephone Number	:	860-322-6302
Fax Number	:	860-854-2204

Provider Business Practice Location Address
First Line	:	6120 FLOWER ST
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-5340
Country	:	US
Telephone Number	:	860-235-5684
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	CAITLIN WARD
Credential	:	LCSW
Telephone Number	:	860-235-5684

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	05/08/2026

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