Phoenix Rising Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PHOENIX RISING WELLNESS LLC

Practice address

153 S Main St
Newtown, CT 06470-2791

Phone

(203) 556-2030

NPI assigned

Apr 19, 2024

Last updated

Aug 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alyssa Kondor, LCSWNPI 1164991451

Title

Owner

Phone

(203) 556-2030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alyssa Ashly Kondor, LCSW

  • Clinical Social Worker
  • Newtown, CT
  • NPI 1164991451
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787961600000",
    "number": "1114772456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 YALE AVE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622712",
            "telephone_number": "203-556-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 S MAIN ST",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702791",
            "telephone_number": "203-556-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A",
        "authorized_official_last_name": "KONDOR",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-556-2030",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul R & Stephanie K Berry Dba Physical Therapy Consultants
• Paul R Berry
• Jason Ramos Pereira
• Lisa Marie Perry, LPC
• Peter Licht M.D. & Jennifer Holloway M.D LLC.
• Mark Pirner, MD
• Jill Pluta, LMFT
• John M Popowich, DC
• Ashley Portela, APRN
• Dylan Puglisi, D.D.S

• Clinical Social Worker in Newtown, CT
• Providers in Newtown, 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 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.