Regenerative Psychotherapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REGENERATIVE PSYCHOTHERAPY PLLC

Practice address

95 Long Lots Rd
Westport, CT 06880-3919

Phone

(917) 224-9598

NPI assigned

Aug 31, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Merritt Juliano, JD LCSW

Title

Managing Member

Phone

(917) 224-9598

Specialties & licenses 1

Addresses

Other names 1

• Regenerative Psychotherapy PLLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1003420829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 LONG LOTS RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803919",
            "telephone_number": "917-224-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LONG LOTS RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803919",
            "telephone_number": "917-224-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "JULIANO",
        "authorized_official_first_name": "MERRITT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "917-224-9598",
        "authorized_official_credential": "JD LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regenerative Psychotherapy PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Westport, CT
• Providers in Westport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.