Organization Active NPI

Your Peace of Mind Therapeutic Services, LLC

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1821799396
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
YOUR PEACE OF MIND THERAPEUTIC SERVICES, LLC
Practice address
682 Prospect Ave Ste 103
Hartford, CT 06105-4238
Phone
(860) 663-8131
NPI assigned
Mar 13, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Jessica Lazu, LCSWNPI 1144816158
Title
Business Owner
Phone
(860) 663-8131

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: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

682 Prospect Ave Ste 103
Hartford, CT 06105-4238

Mailing address

682 Prospect Ave Ste 103
Hartford, CT 06105-4238
Phone (860) 663-8131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230621002192 CT Part B Supplier - Clinic/Group Practice 3577921618 Receives reassigned benefits from 1 practitioner
Practice locations: Hartford, CT; Rocky Hill, CT

National Provider Directory

National Provider Directory

Locations

674 Prospect Ave
Ste 205
Hartford, CT 06105
Phone (860) 817-5762

682 Prospect Ave
Ste 103
Hartford, CT 06105
Phone (860) 490-7236

175 Capital Blvd
Ste 431
Rocky Hill, CT 06067

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1821799396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 PROSPECT AVE STE 103",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054238",
            "telephone_number": "860-663-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 PROSPECT AVE STE 103",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054238",
            "telephone_number": "860-663-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR PEACE OF MIND THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "LAZU",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "860-663-8131",
        "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": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.