# INTEGRATED WELLNESS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003096744
- **Authorized official:** DR. MAYSA AKBAR PH.D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (203) 387-9400

## Contact information

- **Practice address:** 446A BLAKE STREET, SUITE 200, NEW HAVEN, CT 06515-2216
- **Practice address phone:** (203) 387-9400
- **Practice address fax:** (888) 772-2160
- **Mailing address:** 446A BLAKE ST, SUITE 200, NEW HAVEN, CT 06515-1286
- **Mailing address phone:** (203) 387-9400
- **Mailing address fax:** (888) 772-2160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | 001636 | CT | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 002659 | CT | Yes |
| 1041C0700X | Clinical Social Worker | 005442 | CT | — |
| 1041C0700X | Clinical Social Worker | 006473 | CT | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 11/09/2007
- **Last updated:** 09/09/2010