Individual provider Active NPI

Marcy T. Pitkin

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1215996020
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW2430 Issued in FL
Practice address
909 SE Central Pkwy
Suite 100
Stuart, FL 34994-3904
Phone
(772) 286-8093
Fax
(772) 286-8093
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2010

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 SW2430 FL Primary

Addresses

Primary practice location

909 SE Central Pkwy
Suite 100
Stuart, FL 34994-3904

Mailing address

1480 SE 13TH St
Stuart, FL 34996-5812
Phone (772) 286-8093

Other identifiers 1

IdentifierTypeStateIssuer
1215996020OtherNIPPES

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1215996020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 SE 13TH ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349965812",
            "telephone_number": "772-286-8093",
            "fax_number": "772-286-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SE CENTRAL PKWY",
            "address_2": "SUITE 100",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943904",
            "telephone_number": "772-286-8093",
            "fax_number": "772-286-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITKIN",
        "first_name": "MARCY",
        "middle_name": "T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NIPPES",
            "identifier": "1215996020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.