Nicole Bunnell, LCSW

Key facts

NPI

1194154344

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

006424 (CT)

Practice address

159 Meadow St
Naugatuck, CT 06770-4042

Phone

(203) 695-1108

NPI assigned

Nov 8, 2013

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 8, 2013.

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1194154344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LAURA LN",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781830",
            "telephone_number": "203-695-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MEADOW ST",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704042",
            "telephone_number": "203-695-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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