Individual provider Active NPI

Kelly Marie Zando, LMSW

  • Social Worker
  • Stratford, CT
National Provider Identifier
1144930124
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MSW.004132 Issued in CT
Practice address
110 Brookbend Dr
Stratford, CT 06614-3011
Phone
(203) 610-7317
NPI assigned
Nov 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X 4132 CT
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X MSW.004132 CT Primary

Addresses

Primary practice location

110 Brookbend Dr
Stratford, CT 06614-3011

Mailing address

110 Brookbend Dr
Stratford, CT 06614-3011
Phone (203) 610-7317

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
MSW.004132CTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1144930124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BROOKBEND DR",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143011",
            "telephone_number": "203-610-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BROOKBEND DR",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143011",
            "telephone_number": "203-610-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDO",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "CT",
            "license": "4132",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "CT",
            "license": "MSW.004132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.