Individual provider Active NPI

Tatiana Sloutsky, L.I.C.S.W.

  • Clinical Social Worker
  • Salem, MA
National Provider Identifier
1043458706
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW110577 Issued in MA
Practice address
27 Congress St Ste 305-03
Salem, MA 01970-5510
Phone
(978) 594-3669
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW110577 MA Primary

Addresses

Primary practice location

27 Congress St Ste 305-03
Salem, MA 01970-5510

Mailing address

27 Congress St Ste 305-03
Salem, MA 01970-5510
Phone (978) 594-3669

Other practice location 1

27 Congress St Ste 305-03
Salem, MA 01970-5510
Phone (978) 594-3669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150310000431 MA Practitioner - Clinical Social Worker 2567788599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

27 Congress St
Suite 305 03
Salem, MA 01970-5510
Phone (978) 594-3669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW110577MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Light Paths Counseling LLC Clinical CurrentSince Jan 8, 2018 Accepting new patients

Locations

27 Congress St
Ste 30503
Salem, MA 01970
Phone (978) 335-7148

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1043458706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CONGRESS ST STE 305-03",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705510",
            "telephone_number": "978-594-3669",
            "fax_number": "978-594-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CONGRESS ST STE 305-03",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705510",
            "telephone_number": "978-594-3669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Congress St Ste 305-03",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019705510",
            "country_code": "US",
            "telephone_number": "978-594-3669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLOUTSKY",
        "first_name": "TATIANA",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "SW110577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.