BACKCOUNTRY WELLNESS LLC – NPI #1568959815
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Health Care Provider Taxonomy Code for Clinic/Center

BACKCOUNTRY WELLNESS LLC is an AHC clinic located in GREENWICH, CT. NPPES has assigned the NPI number 1568959815 to BACKCOUNTRY WELLNESS LLC on April 21, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health

The NPI profile was previously updated about 5 years ago on Mar 04, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BACKCOUNTRY WELLNESS LLC below.

NPI Profile for
BACKCOUNTRY WELLNESS LLC

NPI Number
1568959815
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BACKCOUNTRY WELLNESS LLC
Primary location
7 LINCOLN AVENUE
GREENWICH, CT 06830
Phone: (203) 992-1700 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JOANN BRONFMAN
OWNER/DIRECTOR
Phone: (914) 755-6472
Updated
Certification Date
Sep 22, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0855X
- Clinic/Center / Adolescent and Children Mental Health (Primary)
1041C0700X
- Social Worker / Clinical		 CT CT006838

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.