NPIMap

Organization Active NPI

Open Space Therapy LLC

  • Clinical Social Worker
  • East Hartford, CT
National Provider Identifier
1649892084
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPEN SPACE THERAPY LLC
Practice address
28 Higbie Dr
East Hartford, CT 06108-2840
Phone
(860) 995-0730
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Jocelyn Flores, LCSWNPI 1104315456
Title
Chief Executive Officer
Phone
(860) 995-0730

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

28 Higbie Dr
East Hartford, CT 06108-2840

Mailing address

28 Higbie Dr
East Hartford, CT 06108-2840
Phone (860) 995-0730

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1649892084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 HIGBIE DR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082840",
            "telephone_number": "860-995-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HIGBIE DR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082840",
            "telephone_number": "860-995-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN SPACE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "860-995-0730",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.