WATERTOWN WELLNESS CENTER LLC NPI 1396232187

NPI Information

NPI: 1396232187
Provider Name: WATERTOWN WELLNESS CENTER LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

CLIA Number: 07D2118323

Address:
116 GEORGETOWN DRIVE
WATERTOWN, CT
ZIP 06795
Phone: (203) 592-7898
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WATERTOWN WELLNESS CENTER LLC is a professional counselor in Watertown, CT. WATERTOWN WELLNESS CENTER LLC NPI is 1396232187. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

116 GEORGETOWN DRIVE
WATERTOWN, CT
ZIP 06795
Phone: (203) 592-7898

The provider's authorized official is Laura Anne Manderino .
The authorized official title is Owner/licensed Psychotherapist and has the following contact phone number (203) 592-7898.

The CLIA number assigned to this NPI record is 07D2118323 - other - ems with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2018 and was last updated on 4/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	003013	CONNECTICUT	Yes
2	251S00000X	Community/Behavioral Health				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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