Individual provider Active NPI

Liz Cristina Schacht, LCSW, MSW

  • Clinical Social Worker
  • Wallingford, CT
National Provider Identifier
1245665793
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
012693 Issued in CT
Practice address
6 Laura LN
Wallingford, CT 06492-2924
Phone
(203) 506-9910
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 012693 CT Primary

Addresses

Primary practice location

6 Laura LN
Wallingford, CT 06492-2924

Mailing address

6 Laura LN
Wallingford, CT 06492-2924
Phone (203) 506-9910

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidCT
PENDINGOtherCAQH

Other names 1

  • Mrs. Liz Cristina Holley Former name

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
012693CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1245665793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LAURA LN",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922924",
            "telephone_number": "203-506-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LAURA LN",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922924",
            "telephone_number": "203-506-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACHT",
        "first_name": "LIZ",
        "middle_name": "CRISTINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "HOLLEY",
            "middle_name": "CRISTINA",
            "prefix": "MRS.",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.