Ec Thera-Fit Group, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EC THERA-FIT GROUP, LLC

Practice address

900 Main St
Oakville, CT 06779-1999

Phone

(860) 856-3380

NPI assigned

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Dwayne Clements Jr.

Title

Manager

Phone

(860) 856-3380

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

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

• Evelyn Diaz, LCSW

  • Clinical Social Worker
  • Waterbury, CT
  • NPI 1316379969
  Medicare reassignment NPD
• Shenira Lynn Billups, NCC, LPC

  • Professional Counselor
  • Hamden, CT
  • NPI 1629419049
  NPD

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1265099667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 SPRING RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067161616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "OAKVILLE",
            "state": "CT",
            "postal_code": "067791999",
            "telephone_number": "860-856-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EC THERA-FIT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-856-3380",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Martin Espano Cayabyab
• Michelle Cominsky
• Connecticut CVS Pharmacy LLC
• Craig W Czarsty, MD
• Amanda Dobler, SLP
• Samantha Allison Edrich, MSN
• Kristi Anne Ehnot
• Michelle Audrey Ehrler
• Kathy Engle-Dulac, LMSW
• Family Junction Birth to Three

• Clinical Social Worker in Oakville, CT
• Providers in Oakville, 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 May 22, 2019; 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.