Interconnection Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTERCONNECTION WELLNESS LLC

Practice address

113 S Perry St Ste 206
Lawrenceville, GA 30046-4811

Phone

(470) 326-6717

NPI assigned

Sep 15, 2023

Organization subpart

No

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

Authorized official

Name

Kristal Alexis Lewis, LCSW

Title

Clinical Social Worker

Phone

(470) 369-0957

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1780462473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S PERRY ST",
            "address_2": "SUITE 206 #9320",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464811",
            "telephone_number": "470-369-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S PERRY ST STE 206",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464811",
            "telephone_number": "470-326-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCONNECTION WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KRISTAL",
        "authorized_official_middle_name": "ALEXIS",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "470-369-0957",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.