Elation Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELATION WELLNESS

Practice address

1057 Broad St
Bridgeport, CT 06604-4219

Phone

(860) 661-2925

NPI assigned

Aug 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Camila Smith, LCSW

Title

Clinician

Phone

(203) 308-7835

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 5

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

• Camila Jasmin Palacio, LCSW

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1326437336
  Medicare reassignment
• Ralph R. Ford Jr., PH.D.

  • Cognitive & Behavioral Psychologist
  • Bridgeport, CT
  • NPI 1083638340
  NPD (past)
• Annemarie Theresa Murphy, PH.D.

  • Psychologist
  • Bridgeport, CT
  • NPI 1043295850
  NPD (past)
• Jose A Olmo, LCSW LICENSED CLINIC

  • Clinical Social Worker
  • Bridgeport, CT
  • NPI 1346338779
  NPD (past)
• Manuel J Rosales, PSY.D.

  • Clinical Psychologist
  • Bridgeport, CT
  • NPI 1346348513
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1487109252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 TOBY HILL RD",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064983521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 BROAD ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044219",
            "telephone_number": "860-661-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELATION WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARIA CAMILA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "203-308-7835",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Ehl
• Ej Ventures 2 LLC
• Jimmy Samir El-Yamani, RPH
• Janine Eladawy, PA
• Elizabeth Elam, CRNA
• Tarig Sami Elhakim, MD, MPH
• Elite Home Care Agency LLC
• Ragaa Elkabbani, MBBS
• Judith Elkies, SLP
• Crystal A Ellis

• Clinical Social Worker in Bridgeport, CT
• Providers in Bridgeport, 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 Apr 2, 2018; 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.