Organization Active NPI

Self Love Therapy

  • Marriage & Family Therapist
  • Manchester, CT
National Provider Identifier
1053026187
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SELF LOVE THERAPY
Practice address
543 N Main St Ste E
Manchester, CT 06042-1973
Phone
(860) 837-0302
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Avina Johnson-Smith, LMFT
Title
Therapist
Phone
(860) 837-0302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

543 N Main St Ste E
Manchester, CT 06042-1973

Mailing address

543 N Main St Ste E
Manchester, CT 06042-1973
Phone (860) 837-0302

National Provider Directory

National Provider Directory

Locations

543 N Main St
Ste E
Manchester, CT 06042
Phone (860) 837-0302

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1053026187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 N MAIN ST STE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421973",
            "telephone_number": "860-837-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 N MAIN ST STE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421973",
            "telephone_number": "860-837-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF LOVE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-SMITH",
        "authorized_official_first_name": "AVINA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "860-837-0302",
        "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": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.