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General NPI Number Information
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NPI Number | 1447039292
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Entity Type | Organization
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Legal Business Name | NORTH STAR WELLNESS
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 34 N STAR DR
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City | SOUTHINGTON
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State | CT
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Zip | 06489-3858
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Country | US
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Telephone | 860-249-1824
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Fax | 833-350-2636
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Provider Business Mailing Address
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Address Line | 34 N STAR DR
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City | SOUTHINGTON
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State | CT
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Zip | 06489-3858
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Country | US
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Telephone | 860-249-1824
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Fax | 833-350-2636
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MRS. KELLI BERNIER
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Credential | NP-C
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Telephone | 860-249-1824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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