Rebellious Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REBELLIOUS WELLNESS, LLC

Practice address

833 Little Meadow Rd
Guilford, CT 06437-5026

Phone

(203) 376-8701

NPI assigned

Mar 18, 2022

Organization subpart

No

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

Authorized official

Name

Helena J Clark, LPCNPI 1811312382

Title

Owner

Phone

(203) 376-8701

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Helena Jeanette Clark, LPC

  • Professional Counselor
  • New Haven, CT
  • NPI 1811312382

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1992454953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 LITTLE MEADOW RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064375026",
            "telephone_number": "203-376-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 LITTLE MEADOW RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064375026",
            "telephone_number": "203-376-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBELLIOUS WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "HELENA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-376-8701",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Louise Randolph, LCSW
• Katrina Ranmal
• Elana Raphael-Tomkins, LCSW
• Nikki Rasmussen, APRN
• Timothy Rausch, RN, MSN, FNP
• Karolin Fee Regan, L.C.S.W.
• Rehab Concepts LLC
• Kendra J. Remington, D.D.S.
• Allison Beth Resnick, DC
• Adriana Restrepo-Powers, LMFT

• Mental Health Counselor in Guilford, CT
• Providers in Guilford, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.