Organization Active NPI

Restoring You Wellness Center LLC

  • Clinical Social Worker
  • Cheshire, CT
National Provider Identifier
1023650090
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RESTORING YOU WELLNESS CENTER LLC
Practice address
1113 S Main St Ste F
Cheshire, CT 06410-3436
Phone
(203) 699-6318
NPI assigned
Oct 11, 2019
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Brittney Jackson, MSW, MBA, LCSWNPI 1639728231
Title
Member
Phone
(203) 699-6318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Clinical Social Worker 1041C0700X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1113 S Main St Ste F
Cheshire, CT 06410-3436

Mailing address

1113 S Main St Ste F
Cheshire, CT 06410-3436
Phone (203) 699-6318

Other practice location 1

707 Green Meadow Ln
Smyrna, TN 37167-5893
Phone (615) 933-6127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191108000780 CT Part B Supplier - Clinic/Group Practice 0749612935 Receives reassigned benefits from 1 practitioner
Practice locations: Cheshire, CT
O20201215000028 TN Part B Supplier - Clinic/Group Practice 0749612935 Receives reassigned benefits from 1 practitioner
Practice locations: Smyrna, TN

National Provider Directory

National Provider Directory

Locations

1113 S Main St
Ste F
Cheshire, CT 06410
Phone (203) 272-7381

51 Depot St
Ste 204
Watertown, CT 06795
Phone (203) 699-6318

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1023650090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 S MAIN ST STE F",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103436",
            "telephone_number": "203-699-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 S MAIN ST STE F",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103436",
            "telephone_number": "203-699-6318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Green Meadow Ln",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "TN",
            "postal_code": "371675893",
            "country_code": "US",
            "telephone_number": "615-933-6127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTORING YOU WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-699-6318",
        "authorized_official_credential": "MSW, MBA, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.