Innerlight Wellness Counseling PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

INNERLIGHT WELLNESS COUNSELING PLLC

Practice address

119C Griswold St Ste 202
Glastonbury, CT 06033-1099

Phone

(860) 918-7946

Fax

(860) 735-5842

NPI assigned

Aug 22, 2023

Organization subpart

No

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

Authorized official

Name

Mandy L Tiedeman, LMFT

Title

Member

Phone

(860) 918-7946

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joy Mitchell, LCSW

  • Clinical Social Worker
  • Hartford, CT
  • NPI 1629462536
  Medicare reassignment NPD

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1043094956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119C GRISWOLD ST STE 202",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331099",
            "telephone_number": "860-918-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119C GRISWOLD ST STE 202",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331099",
            "telephone_number": "860-918-7946",
            "fax_number": "860-735-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERLIGHT WELLNESS COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "TIEDEMAN",
        "authorized_official_first_name": "MANDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-918-7946",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hiba Ibad
• Immerse LLC
• Kenneth R Inchalik, MD
• Inner Peace Counseling
• Inner Wisdom Psychotherapy
• Innovative Solutions Counseling, LLC
• Kimberly Inocco, DPM
• Integrated Dermatology of Glastonbury PLLC
• Integrative Clinical Associates
• Intuitive Journey Counseling Services LLC

• Marriage & Family Therapist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.