Individual provider Active NPI

Kristen E Pavlik

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1346617222
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
141 E Main St
Waterbury, CT 06702
Phone
(203) 574-9000
Fax
(203) 574-9006
NPI assigned
Aug 27, 2015
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 Primary

Addresses

Primary practice location

141 E Main St
Waterbury, CT 06702

Mailing address

141 E Main St
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other practice location 1

1287 Strongtown Rd
Southbury, CT 06488-1948
Phone (203) 819-7598

Other names 1

  • Kristen E Kirvela Former name

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1346617222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1287 Strongtown Rd",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064881948",
            "country_code": "US",
            "telephone_number": "203-819-7598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLIK",
        "first_name": "KRISTEN",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KIRVELA",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.