Healthcare Provider Details

I. General information

NPI: 1366379653
Provider Name (Legal Business Name): SOMATIC GROVE WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 NEW BRITAIN AVE STE 1
ROCKY HILL CT
06067-1175
US

IV. Provider business mailing address

15 FOREST GLEN CIR APT 16
MIDDLETOWN CT
06457-6600
US

V. Phone/Fax

Practice location:
  • Phone: 860-882-9273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAMIE PERRY
Title or Position: OWNER
Credential:
Phone: 860-882-9273