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General NPI Number Information
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NPI Number | 1649182361
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Entity Type | Organization
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Legal Business Name | WELL ROOTED PRACTICE LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 99 WHITFIELD ST
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City | GUILFORD
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State | CT
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Zip | 06437-3429
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Country | US
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Telephone | 203-208-9854
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Fax |
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Provider Business Mailing Address
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Address Line | 119 MONTOWESE ST
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City | BRANFORD
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State | CT
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Zip | 06405-3807
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA ANN GREENE
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Credential | LCSW
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Telephone | 203-208-9854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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