Individual provider Active NPI

Steven Michael Baltrush, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1316002082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006337 Issued in CT
Practice address
1302 S Main St
Waterbury, CT 06706-1748
Phone
(203) 597-9044
NPI assigned
Dec 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 006337 CT Primary

Addresses

Primary practice location

1302 S Main St
Waterbury, CT 06706-1748

Mailing address

211 Kissawaug Rd
Middlebury, CT 06762-3232
Phone (203) 758-1738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20070319000274 CT Practitioner - Clinical Social Worker 8527161215 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006337CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 11, 2017 Accepting new patients
State of Connecticut CurrentSince Jan 11, 2017 Accepting new patients

Locations

78 Triangle St
Bldg 14
Danbury, CT 06810
Phone (203) 448-3200

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316002082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 KISSAWAUG RD",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067623232",
            "telephone_number": "203-758-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061748",
            "telephone_number": "203-597-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTRUSH",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.