Harvest Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

HARVEST WELLNESS LLC

Practice address

2661 Whitney Ave
Hamden, CT 06518-2900

Phone

(475) 209-3758

NPI assigned

Aug 23, 2023

Organization subpart

No

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

Authorized official

Name

Mia Wilson, LCSWNPI 1649883943

Title

Owner

Phone

(475) 209-3758

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Mia Wilson, LCSW

  • Clinical Social Worker
  • Hamden, CT
  • NPI 1649883943
  NPD Authorized official

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1326822008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065140105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182900",
            "telephone_number": "475-209-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEST WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "475-209-3758",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649883943",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Harris-Miller
• Brittany Harris
• Christina Harrison, OTR
• Hartford Hospital
• Emma Hartshorn
• Rebecc Harvey, LCSW, PHD
• David J Hass, M.D.
• Bonnie Hataley, P.A.
• Rebecca J Hatfield, MSN-PMHNP-BC
• Ferda Imran Hatiboglu, DMD

• Clinical Social Worker in Hamden, CT
• Providers in Hamden, 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 23, 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.