Authentic Wellness Therapy LLC

Primary specialty

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

Legal business name

AUTHENTIC WELLNESS THERAPY LLC

Practice address

Authentic Wellness Therapy LLC
300 West Main Street, Building B
Northborough, MA 01532

Phone

(508) 471-6410

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

Jillian Garofano-Staines, LMHC

Title

Clinician/Owner

Phone

(508) 471-6410

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1073152153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "STERLING",
            "state": "MA",
            "postal_code": "015640002",
            "telephone_number": "508-471-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AUTHENTIC WELLNESS THERAPY LLC",
            "address_2": "300 WEST MAIN STREET, BUILDING B",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "01532",
            "telephone_number": "508-471-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC WELLNESS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "GAROFANO-STAINES",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "CLINICIAN/OWNER",
        "authorized_official_telephone_number": "508-471-6410",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jillian@authenticwellnesstherapy.com",
            "affiliation": "N",
            "address_1": "Authentic Wellness Therapy LLC",
            "address_2": "300 West Main Street, Building B",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "country_code": "US",
            "postal_code": "01532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.