Organization Active NPI

Open Water Wellness

  • Clinical Social Worker
  • Guilford, CT
National Provider Identifier
1730060724
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPEN WATER WELLNESS
Practice address
1575 Boston Post Rd Ste 2And3
Guilford, CT 06437-2319
Phone
(475) 306-5613
NPI assigned
Sep 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Katie CushmanNPI 1801132857
Title
Partner
Phone
(475) 306-5613

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

1575 Boston Post Rd Ste 2And3
Guilford, CT 06437-2319

Mailing address

1575 Boston Post Rd Ste 2And3
Guilford, CT 06437-2319
Phone (475) 306-5613

National Provider Directory

National Provider Directory

Locations

1575 Boston Post Rd
Ste 2AND3
Guilford, CT 06437
Phone (475) 306-5613

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": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1730060724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 BOSTON POST RD STE 2AND3",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372319",
            "telephone_number": "475-306-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BOSTON POST RD STE 2AND3",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372319",
            "telephone_number": "475-306-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN WATER WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "CUSHMAN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "475-306-5613"
    },
    "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 Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.