Organization Active NPI

Journey of Life Wellness Center LLC

  • Clinical Social Worker
  • Woodbridge, CT
National Provider Identifier
1669008389
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
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

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Esther Duncan, LCSWNPI 1356773725
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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.