Individual provider Active NPI

Sudha Gutti, MSW, LCSW

  • Social Worker
  • Phoenixville, PA
National Provider Identifier
1295367308
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW128791 Issued in PA
Practice address
1041 W Bridge St # B5
Phoenixville, PA 19460-4342
Phone
(610) 415-9301
Fax
(610) 415-1656
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW128791 PA Primary

Addresses

Primary practice location

1041 W Bridge St # B5
Phoenixville, PA 19460-4342

Mailing address

1041 W Bridge St # B5
Phoenixville, PA 19460-4342
Phone (610) 415-9301

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306003765 PA Practitioner - Clinical Social Worker 3779929278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fellowship Health Resources IncGroup PAC ID 8224022546, 14 clinicians

Practice addresses (Care Compare)

1041 W Bridge St
Suite 5
Phoenixville, PA 19460-4342
Phone (610) 415-9301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW128791PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Health Resources, Inc CurrentSince Dec 31, 2023 Accepting new patients

Locations

1041 W Bridge St
#B5
Phoenixville, PA 19460
Phone (610) 415-9301

1041 W Bridge St
Phoenixville, PA 19460
Phone (610) 415-9301

1041 W Bridge St
Ste 5
Phoenixville, PA 19460
Phone (610) 415-9301

24 Albion Rd
Ste 420
Lincoln, RI 02865
Phone (401) 333-3980

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702684800000",
    "number": "1295367308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 W BRIDGE ST # B5",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604342",
            "telephone_number": "610-415-9301",
            "fax_number": "610-415-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 W BRIDGE ST # B5",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604342",
            "telephone_number": "610-415-9301",
            "fax_number": "610-415-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTI",
        "first_name": "SUDHA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW128791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "address_1": "1041 W Bridge St # B5",
            "city": "Phoenixville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194604342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

Verify at the official NPI Registry.