Individual provider Active NPI

Michelle Ann Pennington

  • Clinical Social Worker
  • Westfield, MA
National Provider Identifier
1124560313
Registry record updated Nov 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004341 Issued in CT
Practice address
175 Falcon Dr
Westfield, MA 01085-1482
Phone
(413) 568-9151
NPI assigned
Nov 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2016

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 004341 CT Primary

Addresses

Primary practice location

175 Falcon Dr
Westfield, MA 01085-1482

Mailing address

175 Falcon Dr
Westfield, MA 01085-1482
Phone (413) 568-9151

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
004341CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1478390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478390400000",
    "number": "1124560313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FALCON DR",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010851482",
            "telephone_number": "413-568-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FALCON DR",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010851482",
            "telephone_number": "413-568-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-06",
        "last_updated": "2016-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2016; 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.