MEDICARE: KELLY PANAS PH.D.

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	103TC0700X	Clinical Psychologist	004309	CT

General Provider Information

NPI Number	:	1386990802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY PANAS PH.D.

Provider Business Mailing Address
First Line	:	2389 MAIN ST STE 100
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-4617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2389 MAIN ST STE 100
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-4617
Country	:	US
Telephone Number	:	860-266-7872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2012
Last Update Date	:	11/11/2024

Similar Medicare Providers

1003388919 — MRS. LAURA ELIZABETH GABRIEL APRN
Practice Location Address:

2389 MAIN ST STE 100
GLASTONBURY, CT
06033-4617

Practice Phone: 860-777-5829
Practice Fax:

1184956849 — JOANNE HUTT, PH.D., LLC
Practice Location Address:

2389 MAIN ST
GLASTONBURY, CT
06033-4617

Practice Phone: 860-918-4324
Practice Fax: 860-432-8330

1164736310 — FORTUNE BILLING SERVICES
Practice Location Address:

2389 MAIN ST
GLASTONBURY, CT
06033-4617

Practice Phone: 860-659-6553
Practice Fax:

1568904647 — WENDY LEVINE LPC
Practice Location Address:

2389 MAIN ST STE 100
GLASTONBURY, CT
06033-4617

Practice Phone: 201-452-7517
Practice Fax:

1609388867 — KAITLIN E. SMITH LCSW
Practice Location Address:

2389 MAIN ST STE 1
GLASTONBURY, CT
06033-4617

Practice Phone: 860-629-0107
Practice Fax: 860-613-6297

1316408545 — CCT CARE OF CT, LLC
Practice Location Address:

2389 MAIN ST
GLASTONBURY, CT
06033-4617

Practice Phone: 615-386-0064
Practice Fax:

Directions to “ KELLY PANAS PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.