Weave Your Life LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006194 Issued in CT

Legal business name

WEAVE YOUR LIFE LLC

Practice address

963 Queen St
Suite C
Southington, CT 06489-1282

Phone

(860) 819-8570

NPI assigned

Mar 4, 2010

Organization subpart

No

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

Authorized official

Name

Audrey L Bennett

Title

Manager

Phone

(860) 819-8570

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1104149293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 QUEEN ST",
            "address_2": "SUITE C",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891282",
            "telephone_number": "860-819-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 QUEEN ST",
            "address_2": "SUITE C",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891282",
            "telephone_number": "860-819-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEAVE YOUR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-819-8570"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006194",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "006194",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "000729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008040743",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Wang
• Yelena Wasser
• Watertown Medical Associates, LLC
• Waves of Change Counseling Services, LLC
• Judith Wayton, LPC
• Christine Welch-Meier, LCSW
• William Henry Welch III, D.D.S.
• Laura White, RN, BSN, IBCLC
• Laura P White, LCSW
• Sandra J White

• Clinical Social Worker in Southington, CT
• Providers in Southington, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.