Organization · NPI-2

A Prospering Vision, LLC

Social Worker, Clinical · Waterbury, CT

NPI number1932473527
StatusActive
Last updated in NPPESNov 22, 2016

Details

NPI
1932473527
Entity type
Organization (NPI-2)
Legal business name
A Prospering Vision, LLC
Organization subpart
No
Enumeration date
Feb 29, 2012
Last updated
Nov 22, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes
251S00000X Community/Behavioral Health54084595001CT
363LF0000X Nurse Practitioner, Family5149CT
2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging040650CT

Practice location

60 N Main St
3rd Flr
Waterbury, CT 06702-1443

Phone 203-558-9865

Mailing address

60 N Main St
3rd Flr
Waterbury, CT 06702-1443

Phone 203-558-9865

Authorized official

Elijah Caldwell
Executive Program Director
2035589865

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