MYSTIC SERVICES, LLC
NPI 1720619364
Community/Behavioral Health in Mystic, CT

Q: What is Mystic Services, LLC's NPI number?

The NPI number for Mystic Services, LLC is 1720619364. It was assigned to this organization in the NPPES registry on February 2, 2020. The provider is doing business as Mystic Bridge to Wellness.

Q: What is Mystic Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since February 02, 2020

47 WATER ST STE 202, MYSTIC, CT 06355(617) 416-0597(860) 415-0018 Get Directions Write a Review

NPPES record last updated: February 2, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mystic Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYSTIC SERVICES, LLC (NPI 1720619364), doing business as Mystic Bridge To Wellness, is a healthcare organization registered as a community/behavioral health in Mystic, Connecticut and active in the NPI registry since February 2020. The organization lists Lauren E St. Amour, Licensed Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1720619364

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameMYSTIC SERVICES, LLC

Location Address47 WATER ST STE 202Mystic, CT 06355-2573

Mailing Address11 Joyce StMystic, CT 06355-2947 · (617) 416-0597 · Fax (860) 415-0018

Phone(617) 416-0597

Fax(860) 415-0018

Organization SubpartNo

Authorized OfficialLauren E St. AmourLicensed Clinical Social Worker · (617) 416-0597

Enumeration DateFebruary 2, 2020

✔ NPI 1720619364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

47 WATER ST STE 202, Mystic, CT 06355

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Other Names 1

Doing Business AsMystic Bridge To Wellness

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mystic Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mystic Services, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lauren St Amour, LCSW

Clinical Social Worker

NPI 1659412153

47 WATER ST STE 202
Mystic, CT 06355

(617) 416-0597

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mystic Services, LLC's NPI number?

The NPI number for Mystic Services, LLC is 1720619364. It was assigned to this organization in the NPPES registry on February 2, 2020. The provider is doing business as Mystic Bridge to Wellness.

Where is Mystic Services, LLC located?

Mystic Services, LLC is located at 47 Water St Ste 202, Mystic, CT 06355. The listed phone number is (617) 416-0597.

What is Mystic Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Mystic Services, LLC enrolled in Medicare?

Yes. Mystic Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mystic Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Mystic Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mystic Services, LLC was last updated on February 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.