Individual provider Active NPI

Erica Lee Opromollo

  • Clinical Social Worker
  • Watertown, CT
National Provider Identifier
1083841456
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006969 Issued in CT
Practice address
35 Scott Ave
Watertown, CT 06795
Phone
(860) 318-5288
NPI assigned
Jun 12, 2009
Last updated
Jul 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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 006969 CT Primary

Addresses

Primary practice location

35 Scott Ave
Watertown, CT 06795

Mailing address

35 Scott Ave
Watertown, CT 06795-2518
Phone (860) 318-5288

Other practice location 1

1061 E Main St
Torrington, CT 06790-3968
Phone (860) 489-3391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006969CTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1083841456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SCOTT AVE",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952518",
            "telephone_number": "860-318-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SCOTT AVE",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "06795",
            "telephone_number": "860-318-5288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 E Main St",
            "address_purpose": "LOCATION",
            "city": "Torrington",
            "state": "CT",
            "postal_code": "067903968",
            "country_code": "US",
            "telephone_number": "860-489-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPROMOLLO",
        "first_name": "ERICA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.