Healthcare Provider Details

I. General information

NPI: 1578920187
Provider Name (Legal Business Name): GREATER HARTFORD WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 AVON MEADOW LN STE 201
AVON CT
06001-3753
US

IV. Provider business mailing address

40 AVON MEADOW LN STE 201
AVON CT
06001-3753
US

V. Phone/Fax

Practice location:
  • Phone: 860-878-2028
  • Fax: 860-470-5523
Mailing address:
  • Phone: 860-878-2028
  • Fax: 860-470-5523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number3003
License Number StateCT

VIII. Authorized Official

Name: DR. KATHLEEN C WAWRZYNIAK WEBB
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 860-878-0219