Individual provider Active NPI

Amy K Arruda

  • Clinical Social Worker
  • Middlebury, CT
National Provider Identifier
1154893337
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10410 Issued in CT
Practice address
2030 Straits Tpke
Middlebury, CT 06762-1831
Phone
(203) 725-3345
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 10410 CT
Mental Health Counselor 101YM0800X 10410 CT
Clinical Social Worker 1041C0700X 10410 CT Primary

Addresses

Primary practice location

2030 Straits Tpke
Middlebury, CT 06762-1831

Mailing address

168 Clapboard Rd
Bridgewater, CT 06752-1337

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
10410CTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1154893337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 CLAPBOARD RD",
            "city": "BRIDGEWATER",
            "state": "CT",
            "postal_code": "067521337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621831",
            "telephone_number": "203-725-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARRUDA",
        "first_name": "AMY",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CT",
            "license": "10410",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "10410",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.