Live Well LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIVE WELL LLC

Practice address

1331 Burnside Ave Apt A4
East Hartford, CT 06108-1577

Phone

(240) 408-0736

NPI assigned

May 8, 2024

Organization subpart

No

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

Authorized official

Name

Theresa Antwi, PMHNPNPI 1053081398

Title

Aprn

Phone

(240) 408-0736

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Theresa Antwi

  • Psychiatric/Mental Health Nurse Practitioner
  • East Hartford, CT
  • NPI 1053081398

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1093563645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W MAIN ST STE 2",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014355",
            "telephone_number": "240-408-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 BURNSIDE AVE APT A4",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061081577",
            "telephone_number": "240-408-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "ANTWI",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "240-408-0736",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Dionne Littlejohn-Sergeant, LMSW
• Kelly Littlejohn Jr., LMSW
• James Logan
• Lisset Lolandesacosta
• Gabino Lomeli, M.D.
• Lakia Long
• Michelene M Longo, LADC

• Psychiatric/Mental Health Nurse Practitioner in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.