Envision Therapies, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ENVISION THERAPIES, LLC

Doing business as

Envision Therapies, LLC

Practice address

50 Founders PLZ Ste 202
East Hartford, CT 06108-3209

Phone

(860) 689-4222

NPI assigned

May 31, 2020

Last updated

Aug 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandy KennersonNPI 1912545203

Title

Sole Member

Phone

(860) 689-4222

Specialties & licenses 1

Addresses

Other names 1

• Envision Therapies, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandy Michelle Kennerson, LCSW

  • Clinical Social Worker
  • East Hartford, CT
  • NPI 1912545203
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1760006373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LANTERN RIDGE RD",
            "city": "BEACON FALLS",
            "state": "CT",
            "postal_code": "064031473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FOUNDERS PLZ STE 202",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083209",
            "telephone_number": "860-689-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION THERAPIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-31",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "KENNERSON",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "860-689-4222"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Envision Therapies, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.