A Tree of Life Counseling Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

A TREE OF LIFE COUNSELING CENTER

Practice address

3 Barnard LN Ste 310
Bloomfield, CT 06002-2495

Phone

(860) 455-3384

NPI assigned

Feb 18, 2019

Organization subpart

No

Name

Mrs. Kristen Larson-Samalus, LCSWNPI 1386952877

Title

Owner/Director

Phone

(860) 455-3384

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

• Kristen Nicole Larson-Samalus, LCSW

  • Clinical Social Worker
  • Hartford, CT
  • NPI 1386952877

  Clinical

  NPD (past) Authorized official
• Debra Franklin, L.C.S.W.

  • Clinical Social Worker
  • Ellenville, NY
  • NPI 1720101520

  Clinical

  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 11, 2019.

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1124584982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MILLER RD",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269735",
            "telephone_number": "860-455-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BARNARD LN STE 310",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022495",
            "telephone_number": "860-455-3384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 E Granby Rd",
            "address_purpose": "LOCATION",
            "city": "Granby",
            "state": "CT",
            "postal_code": "060352201",
            "country_code": "US",
            "telephone_number": "860-455-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A TREE OF LIFE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LARSON-SAMALUS",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "860-455-3384",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bloomfield, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.