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 | 1041C0700X | Social Worker | Clinical | 008711 | CONNECTICUT | Yes |
| 2 | 1041C0700X | Social Worker | Clinical | 082084 | NEW YORK | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 12755484 | OTHER | CONNECTICUT | CAQH |
| 2 | 140008711CT02 | OTHER | CONNECTICUT | ANTHEM BCBS OF CT -AWAKEN THE POWER THERAPY, LLC |
| 3 | 472092928 | OTHER | CONNECTICUT | FEI BEHAVIORAL HEALTH AWAKEN THE POWER THERAPY, LLC |
| 4 | PENDING | OTHER | CONNECTICUT | OPTUM BEHAVIORAL HEALTH-UNITED HEALTHCARE AWAKEN THE POWER THERAPY |
| 5 | PENDING | OTHER | CONNECTICUT | OPTUM BEHAVIORAL HEALTH CONNECTICARE- AWAKEN THE POWER THERAPY, LLC |
| 6 | 004040655 | OTHER | CONNECTICUT | HP-MEDICAID |
| 7 | 472092928 | OTHER | CONNECTICUT | THREE RIVERS AWAKEN THE POWER THERAPY, LLC |
| 8 | 4990903 | OTHER | CONNECTICUT | CIGNA BEHAVIORAL HEALTH -AWAKEN THE POWER THERAPY |
| 9 | 0060808 | OTHER | CONNECTICUT | BEACON HEALTH- VALUE OPTIONS AWAKEN THE POWER THERAPY, LLC |
| 10 | 472092928 | OTHER | CONNECTICUT | HEALTHY CT- AWAKEN THE POWER THERAPY, LLC |
| 11 | PENDING | OTHER | CONNECTICUT | OPTUM BEHAVIORAL HEALTH- OXFORD/FREEDOM AWAKEN THE POWER THERAPY, LLC |
| 12 | 472092928 | OTHER | CONNECTICUT | MULTI-PLAN -AWAKEN THE POWER THERAPY, LLC |
| 13 | PENDING | OTHER | CONNECTICUT | OPTUM BEHAVIORAL HEALTH- UHC AWAKEN THE POWER THERAPY, LLC |
