Active NPI
Annamaria Chittim, M.ED.
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1124166889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4032
- Practice address
- 120 Granite St
School Age Mothers Program
Worcester, MA 01604-4501 - Phone
- (508) 856-7373
- Fax
- (508) 856-9481
- NPI assigned
- Feb 2, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4032 | MA | Primary |
Addresses
Primary practice location
120 Granite St
School Age Mothers Program
Worcester, MA 01604-4501
Mailing address
120 Granite St
School Age Mothers Program
Worcester, MA 01604-4501
Phone (508) 856-7373
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4032 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189987200000",
"number": "1124166889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 GRANITE ST",
"address_2": "SCHOOL AGE MOTHERS PROGRAM",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044501",
"telephone_number": "508-856-7373",
"fax_number": "508-856-9481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 GRANITE ST",
"address_2": "SCHOOL AGE MOTHERS PROGRAM",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016044501",
"telephone_number": "508-856-7373",
"fax_number": "508-856-9481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHITTIM",
"first_name": "ANNAMARIA",
"credential": "M.ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2007-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.