Lift Pathways to Renewal

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

LIFT PATHWAYS TO RENEWAL

Practice address

8 Myrtle Ave
Westport, CT 06880-3511

Phone

(203) 526-3215

NPI assigned

Apr 28, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Anne Dobson, LMFT

Title

Ceo

Phone

(203) 526-3215

Specialties & licenses 3

Addresses

Other names 1

• Lift Teen & Parent Wellness Centers Doing business as

Tax ID family

Lift Pathways to Renewal2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lift Teen and Parent Wellness Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westport, CT
  • NPI 1053160697
  NPD tax ID

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1831887793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MILE COMMON RD",
            "city": "EASTON",
            "state": "CT",
            "postal_code": "066121506",
            "telephone_number": "203-526-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MYRTLE AVE",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803511",
            "telephone_number": "203-526-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFT PATHWAYS TO RENEWAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "DOBSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-526-3215",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lift Teen & Parent Wellness Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adriana Liberatore, MS, RDN
• Kathryn Lauren Liebenberg, PSYD
• Bernard L Lieberman, M.D.
• Judith Lieberstein, PSYD
• Life Bridge Dental CT PLLC
• Lift Teen and Parent Wellness Centers
• Lift Wellness Group, LLC
• Lindsay Boudreau Counseling LLC
• Doris Lippman
• Kenneth J Lippman, M.D.

• Adolescent and Children Mental Health Clinic/Center in Westport, CT
• Providers in Westport, CT by specialty
• Adolescent and Children Mental Health Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.