Applied Therapeutic Support, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008767 Issued in CT

Legal business name

APPLIED THERAPEUTIC SUPPORT, LLC

Practice address

310 Main St
Lower Level
East Haven, CT 06512-2919

Phone

(203) 444-7778

Fax

(203) 404-7126

NPI assigned

Dec 16, 2014

Last updated

Dec 16, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth M Shea, LCSWNPI 1043617806

Title

Owner

Phone

(203) 444-7778

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth M. Shea, LCSW

  • Clinical Social Worker
  • East Haven, CT
  • NPI 1043617806
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1407254873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 LIMEWOOD AVE",
            "address_2": "#B12",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064055340",
            "telephone_number": "203-444-7778",
            "fax_number": "203-404-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "address_2": "LOWER LEVEL",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122919",
            "telephone_number": "203-444-7778",
            "fax_number": "203-404-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLIED THERAPEUTIC SUPPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-444-7778",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in East Haven, CT
• Providers in East Haven, 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 Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.