Mary Fetchet, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4410 Issued in CT

Practice address

11TH, 161 Cherry Street
Voices of September
New Canaan, CT 06840

Phone

(203) 966-3911

Fax

(203) 966-5701

NPI assigned

Apr 6, 2012

Last updated

Apr 6, 2012By 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

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bridgesct/r4/

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.

• Bridges Healthcare Inc.

  • Adult Mental Health Clinic/Center
  • Milford, CT
  • NPI 1851350300
  NPD (past)

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1346506060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11TH, 161 CHERRY STREET",
            "address_2": "VOICES OF SEPTEMBER",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-966-3911",
            "fax_number": "203-966-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11TH, 161 CHERRY STREET",
            "address_2": "VOICES OF SEPTEMBER",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "06840",
            "telephone_number": "203-966-3911",
            "fax_number": "203-966-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETCHET",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fabican LLC
• Fairfield County Obstetrics & Gynecology, LLC
• Emily B. Farnum, LCSW
• Seymour H Fein, M.D.
• Anthony Thomas Festa, DDS
• Ryan George Flanagan, MD
• Sara J Florio
• William T Flynn, MD
• Flyte Medical of California PC
• Flyte Medical PC

• Clinical Social Worker in New Canaan, CT
• Providers in New Canaan, 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 Apr 6, 2012; 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.