STONY CREEK WELLNESS GROUP LLC NPI 1598209116

NPI Information

NPI: 1598209116
Provider Name: STONY CREEK WELLNESS GROUP, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 07D0997551

Address:
2415 BOSTON POST RD
UNIT 12
GUILFORD, CT
ZIP 06437
Phone: (203) 693-4566
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STONY CREEK WELLNESS GROUP, LLC is a psychiatric/mental health nurse practitioner in Guilford, CT. STONY CREEK WELLNESS GROUP, LLC NPI is 1598209116. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2415 BOSTON POST RD
UNIT 12
GUILFORD, CT
ZIP 06437-348
Phone: (203) 693-4566
Fax: (203) 457-5970

The provider's authorized official is Tricia L Mignosa .
The authorized official title is Owner and has the following contact phone number (203) 693-4566.

The CLIA number assigned to this NPI record is 07D0997551 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/16/2016 and was last updated on 12/16/2016.

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	1922	CONNECTICUT	No
2	1041C0700X	Social Worker	Clinical	9481	CONNECTICUT	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	5763	CONNECTICUT	Yes

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

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