Healthcare Provider Details

I. General information

NPI: 1932032372
Provider Name (Legal Business Name): EHW MARRIAGE AND FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WALL ST
MADISON CT
06443-3121
US

IV. Provider business mailing address

77 WALL ST
MADISON CT
06443-3121
US

V. Phone/Fax

Practice location:
  • Phone: 203-915-8976
  • Fax:
Mailing address:
  • Phone: 203-915-8976
  • 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: ELIZABETH WILSON
Title or Position: OWNER
Credential: LMFT, LADC, MSW
Phone: 203-915-8976