Individual provider Active NPI

Judy Robin Kopman-Fried, LCSW

  • Clinical Social Worker
  • Wallingford, CT
National Provider Identifier
1144387911
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000579 Issued in CT
Practice address
950 Yale Ave
Wallingford, CT 06492-1858
Phone
(203) 269-3488
Fax
(203) 272-6163
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 000579 CT Primary

Addresses

Primary practice location

950 Yale Ave
Wallingford, CT 06492-1858

Mailing address

950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 269-3488

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

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144387911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-269-3488",
            "fax_number": "203-272-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-269-3488",
            "fax_number": "203-272-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPMAN-FRIED",
        "first_name": "JUDY",
        "middle_name": "ROBIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.