Systemic Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SYSTEMIC PSYCHOTHERAPY, LLC

Practice address

100 Melrose Ave Ste 103
Greenwich, CT 06830-6277

Phone

(203) 970-4738

NPI assigned

Nov 12, 2019

Last updated

Aug 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea De Ott, LCSWNPI 1568746188

Title

Manager

Phone

(203) 321-5379

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea De Ott, LCSW

  • Clinical Social Worker
  • Port Chester, NY
  • NPI 1568746188
  Authorized official Same address or phone
• Vivian Vallejo, MSW

  • Social Worker
  • Greenwich, CT
  • NPI 1467053975
  NPD
• Grecia T Villagomez, MSW

  • Social Worker
  • Greenwich, CT
  • NPI 1245833326
  NPD
• Amy Esquivel

  • Social Worker
  • White Plains, NY
  • NPI 1316548837
  NPD

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1205471307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 LAFAYETTE PL APT 2E",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068305409",
            "telephone_number": "203-321-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MELROSE AVE STE 103",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306277",
            "telephone_number": "203-970-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYSTEMIC PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "DE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-321-5379",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgical Specialists of Greenwich
• Miriam Sussman, PA-C
• Caroline M Sutton, DNP
• Paul B Sygall, M.D
• Symponia Wellness
• Eva Krystyna Szaniawski, M.D.
• Alfonso A Tagliavia, M.D
• Katherine Anne Tague, LPCA
• Cheng-Hung Tai
• John Samuel Tamerin, M.D.

• Clinical Social Worker in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.