MYSTIC BRIDGE TO WELLNESS, LLC
NPI 1750044509
Community/Behavioral Health in Mystic, CT
About Mystic Bridge To Wellness, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MYSTIC BRIDGE TO WELLNESS, LLC (NPI 1750044509) is a healthcare organization registered as a community/behavioral health in Mystic, Connecticut and active in the NPI registry since October 2021. The organization lists Lauren St. Amour, Clinician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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 Bridge To Wellness, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Mystic Bridge To Wellness, LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Bridge To Wellness, LLC's NPI number?
The NPI number for Mystic Bridge To Wellness, LLC is 1750044509. It was assigned to this organization in the NPPES registry on October 19, 2021.
Where is Mystic Bridge To Wellness, LLC located?
Mystic Bridge To Wellness, LLC is located at 47 Water St Ste 202, Mystic, CT 06355. The listed phone number is (617) 416-0597.
What is Mystic Bridge To Wellness, LLC's specialty?
The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.
Is Mystic Bridge To Wellness, LLC enrolled in Medicare?
Yes. Mystic Bridge To Wellness, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mystic Bridge To Wellness, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Mystic Bridge To Wellness, LLC, in Clinical Social Worker and Mental Health Counselor. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Mystic Bridge To Wellness, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Mystic Bridge To Wellness, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mystic Bridge To Wellness, LLC was last updated on October 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mystic Bridge To Wellness, Llc · NPI 1750044509
Community/Behavioral Health organization in Mystic, Connecticut. Organization record, active in the CMS NPPES registry since October 19, 2021.
## Identity
- **NPI:** 1750044509 (Entity type: Organization)
- **Enumerated:** October 19, 2021
- **Primary specialty:** Community/Behavioral Health · taxonomy 251S00000X
- **Organization subpart:** No
- **Authorized official:** Lauren St. Amour, CLINICIAN
## Practice location
- **Address:** 47 WATER ST STE 202, Mystic, CT 06355-2573
- **Phone:** (617) 416-0597
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (2), Mental Health Counselor (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 22, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1750044509) · Data from the CMS NPPES public registry.