Individual provider Active NPI

Timothy Wayne Stanton, LICSW

  • Clinical Social Worker
  • West Springfield, MA
National Provider Identifier
1336275692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104372-1 Issued in MA
Practice address
117 Park Ave
Suite 200
West Springfield, MA 01089-3327
Phone
(413) 209-3124
Fax
(413) 209-3127
NPI assigned
Feb 23, 2007
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 104372-1 MA Primary

Addresses

Primary practice location

117 Park Ave
Suite 200
West Springfield, MA 01089-3327

Mailing address

117 Park Ave
Suite 200
West Springfield, MA 01089-3327
Phone (413) 209-3124

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

State licenses

LicenseStateTypeSpecialty
104372-1MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child &Family Service of Pioneer Valley, Inc Clinical Past Accepting new patients
Center for Human Development, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336275692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 PARK AVE",
            "address_2": "SUITE 200",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893327",
            "telephone_number": "413-209-3124",
            "fax_number": "413-209-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 PARK AVE",
            "address_2": "SUITE 200",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893327",
            "telephone_number": "413-209-3124",
            "fax_number": "413-209-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104372-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.