Individual provider Active NPI

Whitney Southall

  • Other Specialist/Technologist
  • Berlin, CT
National Provider Identifier
1871338814
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
610 Issued in CT
Practice address
369 New Britain Rd Ste C
Berlin, CT 06037-1351
Phone
(860) 543-0618
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X 610 CT Primary

Addresses

Primary practice location

369 New Britain Rd Ste C
Berlin, CT 06037-1351

Mailing address

38 Burnside Ave
Plainville, CT 06062-2806
Phone (860) 543-0618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
610CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Gentle Touch Electrolysis LLC CurrentSince Jul 7, 2024 Accepting new patients

Locations

369 New Britain Rd
Ste C
Kensington, CT 06037
Phone (860) 543-0618

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1871338814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 BURNSIDE AVE",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622806",
            "telephone_number": "860-543-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 NEW BRITAIN RD STE C",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371351",
            "telephone_number": "860-543-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "WHITNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "CT",
            "license": "610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

Sources for this page

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