Awaken the Power Therapy, LLC

Organization Active NPI Clinical Social Worker · Milford, CT

NPI 1194129239 · NPPES record last updated Dec 23, 2019

Key facts

NPI
1194129239
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
8711 (CT)
Legal business name
AWAKEN THE POWER THERAPY, LLC
Practice address
57 Plains Rd Unit 1C
Milford, CT 06461-2573
Phone
(203) 693-1050
Fax
(203) 306-3388
NPI assigned
Oct 17, 2014
Organization subpart
No

Authorized official

Name
Monique E West
Title
Director
Phone
(203) 693-1050

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151222001556 CT Part B Supplier - Clinic/Group Practice 4688975337 Receives reassigned benefits from 1 practitioner
Practice locations: Milford, CT

National Provider Directory

Locations

58 River St
Ste 10
Milford, CT 06460
Phone (203) 693-1050

57 Plains Rd
Ste 11
Milford, CT 06461
Phone (203) 693-1050

57 Plains Rd
Unit 1C
Milford, CT 06461
Phone (203) 494-6565

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X 2524 CT
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X 2867 CT
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC0700X 002950 CT
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X 8711 CT Yes
Marriage & Family Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
106H00000X 1813 CT

Addresses

Primary practice location

57 Plains Rd Unit 1C
Milford, CT 06461-2573

Mailing address

57 Plains Rd Unit 1C
Milford, CT 06461-2573
Phone (203) 693-1050

Other providers in Milford, CT

All providers in Milford, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.