Primal Mental and Physical Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PRIMAL MENTAL AND PHYSICAL HEALTH

Practice address

900 Main St
Oakville, CT 06779-1999

Phone

(203) 456-7335

NPI assigned

May 29, 2019

Last updated

May 29, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shirley Gee

Title

Manager

Phone

(203) 456-7335

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1467010116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BELLEVUE TER",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064833202"
        },
        {
            "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": "203-456-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAL MENTAL AND PHYSICAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "GEE",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-456-7335"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Newsome
• Northwest Hills Youth and Family Services Inc.
• John L Pagano, OT
• Arielle Polites, NBC-HWC
• Darica Potts, LMSW
• Rosa Maria Ramirez
• Tina Marie Rhodes, MSOTR/L
• Catherine Risigo-Wickline, OT
• Jonathan H Russell, LPCA
• Kerry Catherine Rutland, MPA

• 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 29, 2019; 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.