Active NPI
Jessica Duttkin, LCSW
- Clinical Social Worker
- Madison, WI
National Provider Identifier
1124114012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7890
- Practice address
- 2500 Overlook Ter
Madison, WI 53705-2254 - Phone
- (737) 844-3835
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7890 | WI | Primary |
Addresses
Primary practice location
2500 Overlook Ter
Madison, WI 53705-2254
Mailing address
2500 Overlook Ter
Madison, WI 53705-2254
Phone (737) 844-3835
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.va.gov/health-care/get-medical-records/ | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7890 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Family Services | Past | Accepting new patients | |
| Metropolitan Family Services | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Chicago, IL
- NPI 1841460391
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1992767032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1124114012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 OVERLOOK TER",
"city": "MADISON",
"state": "WI",
"postal_code": "537052254",
"telephone_number": "737-844-3835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 OVERLOOK TER",
"city": "MADISON",
"state": "WI",
"postal_code": "537052254",
"telephone_number": "737-844-3835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTTKIN",
"first_name": "JESSICA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7890",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.va.gov/health-care/get-medical-records/",
"affiliation": "N",
"endpointDescription": "website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2500 Overlook Ter",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537052254",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.