Active NPI
Matthew Cheetham, BA
- Clinical Social Worker
- New London, CT
National Provider Identifier
1376360545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 7 Vauxhall St
New London, CT 06320-5711 - Phone
- (860) 437-4550
- Fax
- (860) 661-4262
- NPI assigned
- Sep 20, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
7 Vauxhall St
New London, CT 06320-5711
Mailing address
PO Box 120
New London, CT 06320-0120
Phone (860) 437-4550
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1376360545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 120",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063200120",
"telephone_number": "860-437-4550",
"fax_number": "860-661-4262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 VAUXHALL ST",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063205711",
"telephone_number": "860-437-4550",
"fax_number": "860-661-4262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEETHAM",
"first_name": "MATTHEW",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-20",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
- Alana Chan, P.A.
- Jessica Lyn Chan, APRN
- Lauren E Chaplin, LMFT
- Julia Chase Brand, MD
- Amy S Cheesman, CRNA
- Meggy Chen
- Michael Chianuri, MD
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.