Organization Active NPI

Reset & Restart, LLC

  • Mental Health Counselor
  • Bloomfield, CT
National Provider Identifier
1811389794
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
187695384 Issued in CT
Legal business name
RESET & RESTART, LLC
Doing business as
Reset & Restart Mental Health & Wellness Services
Practice address
701 Cottage Grove Rd Ste A230
Bloomfield, CT 06002-3084
Phone
(860) 706-7592
NPI assigned
Mar 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Dr. Renesha Nichols, DSWNPI 1750549853
Title
Owner
Phone
(860) 706-7592

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 187695384 CT Primary

Addresses

Primary practice location

701 Cottage Grove Rd Ste A230
Bloomfield, CT 06002-3084

Mailing address

701 Cottage Grove Rd Ste A230
Bloomfield, CT 06002-3084
Phone (860) 706-7592

Other names 1

  • Reset & Restart Mental Health & Wellness Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240326001448 CT Part B Supplier - Clinic/Group Practice 3476990409 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomfield, CT

National Provider Directory

National Provider Directory

Locations

701 Cottage Grove Rd
Ste A230
Bloomfield, CT 06002
Phone (860) 242-5274

998 Farmington Ave
West Hartford, CT 06107
Phone (860) 729-6138

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": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1811389794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD STE A230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023084",
            "telephone_number": "860-706-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE RD STE A230",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023084",
            "telephone_number": "860-706-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESET & RESTART, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "RENESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-706-7592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "187695384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reset & Restart Mental Health & Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.