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Organization

INTEGRATED WELLNESS GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAYSA AKBAR PH.D. (EXECUTIVE DIRECTOR)
(203) 387-9400
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
11/09/2007
Last updated
09/09/2010
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