Thriving Potential, PLLC

Key facts

NPI

1346883709

Entity type

Organization (NPI type 2)

Primary specialty

Community/Behavioral Health Agency 251S00000X

Legal business name

THRIVING POTENTIAL, PLLC

Practice address

2 Chapman LN Unit 11
Gales Ferry, CT 06335-1222

Phone

(860) 941-7550

NPI assigned

Oct 17, 2019

Organization subpart

No

Authorized official

Name

Samantha Wilson, LPC

Title

Clinician

Phone

(860) 941-7550

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2019.

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1346883709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HOMESTEAD RD APT D",
            "city": "LEDYARD",
            "state": "CT",
            "postal_code": "063391402",
            "telephone_number": "860-941-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHAPMAN LN UNIT 11",
            "city": "GALES FERRY",
            "state": "CT",
            "postal_code": "063351222",
            "telephone_number": "860-941-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVING POTENTIAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "860-941-7550",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Gales Ferry, CT · Community/Behavioral Health Agency in Connecticut