Individual provider Active NPI

Anna Marie Birchenough, LCSW

  • Psychoanalyst
  • Greenwich, CT
National Provider Identifier
1073278735
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
11797 Issued in CT
Practice address
59 Burning Tree Rd
Greenwich, CT 06830-3505
Phone
(203) 609-1679
NPI assigned
Nov 7, 2021
Last updated
Nov 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 11797 CT Primary

Addresses

Primary practice location

59 Burning Tree Rd
Greenwich, CT 06830-3505

Mailing address

59 Burning Tree Rd
Greenwich, CT 06830-3505
Phone (203) 609-1679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220223001697 CT Practitioner - Clinical Social Worker 4981098613 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11797CTMDPsychoanalyst

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of Stamford, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Jade Psychotherapy LLC CurrentSince Mar 27, 2022 Accepting new patients

Locations

196 Greyrock Pl
Stamford, CT 06901
Phone (203) 324-6127

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1636243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1073278735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BURNING TREE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068303505",
            "telephone_number": "203-609-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 BURNING TREE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068303505",
            "telephone_number": "203-609-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCHENOUGH",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-07",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "CT",
            "license": "11797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.