NPIMap

Organization Active NPI

Small Victories Wellness Services, PLLC

  • Adult Mental Health Clinic/Center
  • Middletown, CT
National Provider Identifier
1861911455
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SMALL VICTORIES WELLNESS SERVICES, PLLC
Practice address
360 Main St Ste 2D
Middletown, CT 06457-3375
Phone
(860) 248-6041
NPI assigned
Sep 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Dr. Carrissa Phipps, PHD
Title
Licensed Psychologist
Phone
(860) 740-2041

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

360 Main St Ste 2D
Middletown, CT 06457-3375

Mailing address

360 Main St Ste 2D
Middletown, CT 06457-3375
Phone (860) 248-6041

Other practice location 1

117 S Lexington St Ste 100
Harrisonville, MO 64701-2444
Phone (860) 248-6046

National Provider Directory

National Provider Directory

Locations

360 Main St
Unit 2D
Middletown, CT 06457
Phone (860) 248-6041

Practitioners & affiliated clinicians

Practitioners 11

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": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1861911455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MAIN ST STE 2D",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573375",
            "telephone_number": "860-248-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MAIN ST STE 2D",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573375",
            "telephone_number": "860-248-6041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 S Lexington St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Harrisonville",
            "state": "MO",
            "postal_code": "647012444",
            "country_code": "US",
            "telephone_number": "860-248-6046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SMALL VICTORIES WELLNESS SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "CARRISSA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "860-740-2041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.