Erin Puzycki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

012161 Issued in CT

Practice address

219 Neck Rd
Madison, CT 06443-2724

Phone

(203) 794-6647

NPI assigned

Jun 29, 2022

Last updated

May 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Changing Tides Therapy, LLC.

  • Clinical Social Worker
  • Madison, CT
  • NPI 1366130007
  NPD Authorized official

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1326770215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NECK RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432724",
            "telephone_number": "203-794-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 NECK RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432724",
            "telephone_number": "203-794-6647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Elm St",
            "address_purpose": "LOCATION",
            "city": "Old Saybrook",
            "state": "CT",
            "postal_code": "064754105",
            "country_code": "US",
            "telephone_number": "860-388-9659 x115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUZYCKI",
        "first_name": "ERIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Gray Potter, OTR/L, BCG, CAPS
• Premier Home Health Care Services, Inc (Premier Home Health Care of Connecticut)
• Priority Health Services LLC
• Lauren Elaine Provini, MD
• Henry Puciato, RN, APRN
• Kaitlin C Quallen, MD
• Rita Rabheru, MD
• Nicholas Geoffrey Rapport
• Rounak Babula Rawal, M.D.
• Nicholas Alexander Read, DO

• Clinical Social Worker in Madison, CT
• Providers in Madison, 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 May 16, 2023; 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.