Organization Active NPI

Wisdom Tree Therapy, LLC

  • Marriage & Family Therapist
  • Hartford, CT
National Provider Identifier
1154199271
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
WISDOM TREE THERAPY, LLC
Practice address
664 Prospect Ave Ste 106
Hartford, CT 06105-4255
Phone
(860) 578-8638
NPI assigned
Dec 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Mr. Natale Teodoro, MACP, LMFTNPI 1447390018
Title
Sole Managing Member
Phone
(860) 578-8638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

664 Prospect Ave Ste 106
Hartford, CT 06105-4255

Mailing address

664 Prospect Ave Ste 106
Hartford, CT 06105-4255
Phone (860) 578-8638

National Provider Directory

National Provider Directory

Locations

664 Prospect Ave
Ste 106
Hartford, CT 06105
Phone (860) 212-9776

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1154199271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 PROSPECT AVE STE 106",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054255",
            "telephone_number": "860-578-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 PROSPECT AVE STE 106",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054255",
            "telephone_number": "860-578-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM TREE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "TEODORO",
        "authorized_official_first_name": "NATALE",
        "authorized_official_title_or_position": "SOLE MANAGING MEMBER",
        "authorized_official_telephone_number": "860-578-8638",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MACP, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.