Individual provider Active NPI

Christine Mullin

  • Clinical Social Worker
  • Farmington, CT
National Provider Identifier
1366041360
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003993 Issued in CT
Practice address
883 Plainville Ave
Farmington, CT 06032-3121
Phone
(860) 794-2064
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 003993 CT Primary

Addresses

Primary practice location

883 Plainville Ave
Farmington, CT 06032-3121

Mailing address

883 Plainville Ave
Farmington, CT 06032-3121
Phone (860) 794-2064

Other names 1

  • Christine Baylock Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Farmington Other

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

State licenses

LicenseStateTypeSpecialty
003993CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1366041360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 PLAINVILLE AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323121",
            "telephone_number": "860-794-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PLAINVILLE AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323121",
            "telephone_number": "860-794-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Farmington",
            "affiliation": "N",
            "endpointDescription": "cooper0403.cm@gmail.com",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Farmington",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Farmington",
            "address_1": "883 Plainville Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060323121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BAYLOCK",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.