FREEDOM LIFE THERAPY AND WELLNESS, LLC (NPI# 1730780818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730780818 |
| Entity Type | Organization |
| Organization Name | FREEDOM LIFE THERAPY AND WELLNESS, LLC |
| Practice Address |
76 Berkeley Rd Middletown CT 06457-4107 |
| Practice Telephone | 8607963069 |
| Mailing Telephone | 8607963069 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | LAQUESHIA CLEMONS (OWNER) |
| Authorized Official Telephone | 8607963069 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
76 BERKELEY RD |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1871091066 | Kiara Moore Therapeutic Services | Clinic/Center | 421 Cicero Xing, Middletown, DE 19709-9860 | 2018-01-23 |
| 1053732883 | Pittman Behavioral Health LLC | Clinic/Center | 102 Sleepy Hollow Dr, Suite 204 Bunker Hill Building, Middletown, DE 19709-5841 | 2013-12-20 |
| 1528341740 | Alessandra Buonopane Md Psychiatry and Addiction LLC | Clinic/Center | 192 S Main St, Middletown, CT 06457-3727 | 2011-09-23 |
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| 1104453562 | Empower Therapy & Wellness LLC | Clinic/Center | 786 Boston Post Rd # 203, Madison, CT 06443-3036 | 2020-03-25 |
| 1386279453 | Pathways To Wellness, LLC | Clinic/Center | 74 Sheldon Ter, New Haven, CT 06511-2006 | 2020-03-09 |
| 1053945196 | Farley Counseling Services | Clinic/Center | 29b Hartford Ave, Granby, CT 06035-2326 | 2020-02-27 |
| 1922630557 | Starfish Family Connections, LLC | Clinic/Center | 1367 Hanover Ave Apt 602, Meriden, CT 06451-6278 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on FREEDOM LIFE THERAPY AND WELLNESS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.