Lift Teen and Parent Wellness Centers

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIFT TEEN AND PARENT WELLNESS CENTERS

Practice address

8 Myrtle Ave
Westport, CT 06880-3511

Phone

(203) 526-3215

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

Mary Dobson, MA, LMFT, CEDS

Title

Ceo, Founder

Phone

(203) 526-3215

Specialties & licenses 1

Addresses

Tax ID family

Lift Pathways to Renewal2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lift Pathways to Renewal

  • Adolescent and Children Mental Health Clinic/Center
  • Westport, CT
  • NPI 1831887793
  NPD tax ID

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1053160697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MILE COMMON RD",
            "city": "EASTON",
            "state": "CT",
            "postal_code": "066121506",
            "telephone_number": "203-526-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MYRTLE AVE",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803511",
            "telephone_number": "203-526-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFT TEEN AND PARENT WELLNESS CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "DOBSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CEO, FOUNDER",
        "authorized_official_telephone_number": "203-526-3215",
        "authorized_official_credential": "MA, LMFT, CEDS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lauren Liebenberg, PSYD
• Bernard L Lieberman, M.D.
• Judith Lieberstein, PSYD
• Life Bridge Dental CT PLLC
• Lift Pathways to Renewal
• Lift Wellness Group, LLC
• Lindsay Boudreau Counseling LLC
• Doris Lippman
• Kenneth J Lippman, M.D.
• Julia Liptak

• Mental Health Clinic/Center (Including Community Mental Health Center) in Westport, CT
• Providers in Westport, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.