Well Living LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WELL LIVING LLC

Practice address

30 Hazel Ter Ste 20
Woodbridge, CT 06525-2240

Phone

(475) 441-4339

NPI assigned

Jun 13, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Antwan Nedd, LCSW

Title

Owner

Phone

(475) 367-9114

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1770142697",
    "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",
            "telephone_number": "475-367-9114"
        },
        {
            "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": "475-441-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "NEDD",
        "authorized_official_first_name": "ANTWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "475-367-9114",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "well.livingllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Bus/Practice email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 Hazel Ter Ste 20",
            "city": "Woodbridge",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065252240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.