Provider Demographics
NPI:1710344809
Name:DARIEN WELLNESS
Entity Type:Organization
Organization Name:DARIEN WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT CARE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CIERA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-883-0464
Mailing Address - Street 1:PO BOX 8176
Mailing Address - Street 2:# 35651
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06836-0161
Mailing Address - Country:US
Mailing Address - Phone:203-883-0464
Mailing Address - Fax:
Practice Address - Street 1:30 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4551
Practice Address - Country:US
Practice Address - Phone:203-883-0464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty