Healthcare Provider Details

I. General information

NPI: 1346153152
Provider Name (Legal Business Name): NS UNIQUE MIND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2389 MAIN ST
GLASTONBURY CT
06033-4617
US

IV. Provider business mailing address

2389 MAIN ST
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 203-427-7225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOHN N MARTINEZ
Title or Position: LICENSED PSYCHOTHERAPIST
Credential: LMFT
Phone: 203-427-7225