Active NPI
Journey of Life Wellness Center LLC
- Clinical Social Worker
- Woodbridge, CT
National Provider Identifier
1669008389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- JOURNEY OF LIFE WELLNESS CENTER LLC
- Practice address
- 30 Hazel Ter Ste 20
Woodbridge, CT 06525-2240 - Phone
- (203) 996-0306
- NPI assigned
- Mar 13, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Esther Duncan, LCSW
- Title
- Partner
- Phone
- (203) 996-0306
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary | ||
| In Home Supportive Care Agency | 253Z00000X |
Addresses
Primary practice location
30 Hazel Ter Ste 20
Woodbridge, CT 06525-2240
Mailing address
30 Hazel Ter Ste 20
Woodbridge, CT 06525-2240
National Provider Directory
National Provider DirectoryLocations
30 Hazel Ter
Ste 20
Woodbridge, CT 06525
Phone (203) 293-7763
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Woodbridge, CT
- NPI 1356773725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584057600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1584057600000",
"number": "1669008389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 HAZEL TER STE 20",
"city": "WOODBRIDGE",
"state": "CT",
"postal_code": "065252240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 HAZEL TER STE 20",
"city": "WOODBRIDGE",
"state": "CT",
"postal_code": "065252240",
"telephone_number": "203-996-0306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOURNEY OF LIFE WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-13",
"last_updated": "2020-03-13",
"certification_date": "2020-03-13",
"status": "A",
"authorized_official_last_name": "DUNCAN",
"authorized_official_first_name": "ESTHER",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "203-996-0306",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Mar 13, 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.