Organization Active NPI

TR Counseling & Wellness LLC

  • Mental Health Counselor
  • Woodbridge, CT
National Provider Identifier
1629494232
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
002448 Issued in CT
Legal business name
TR COUNSELING & WELLNESS LLC
Practice address
30 Hazel Terrace
Suite 11
Woodbridge, CT 06525-2240
Phone
(203) 819-7650
NPI assigned
Mar 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Thomas James Reilly, LPC LADCNPI 1326316886
Title
Owner Therapist
Phone
(203) 819-7650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 000951 CT
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 002448 CT Primary

Addresses

Primary practice location

30 Hazel Terrace
Suite 11
Woodbridge, CT 06525-2240

Mailing address

30 Hazel Ter Ste 11
Woodbridge, CT 06525-2240
Phone (203) 819-7650

Other identifiers 1

IdentifierTypeStateIssuer
008038188MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181217000074 CT Part B Supplier - Clinic/Group Practice 4880939065 Receives reassigned benefits from 3 practitioners
Practice locations: Woodbridge, CT

National Provider Directory

National Provider Directory

Locations

30 Hazel Ter
Ste 11
Woodbridge, CT 06525
Phone (203) 726-0109

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1629494232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAZEL TER STE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252240",
            "telephone_number": "203-819-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAZEL TERRACE",
            "address_2": "SUITE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252240",
            "telephone_number": "203-819-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TR COUNSELING & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER THERAPIST",
        "authorized_official_telephone_number": "203-819-7650",
        "authorized_official_credential": "LPC LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000951",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "002448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008038188",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.