Active NPI
Jennifer Rurak
- Clinical Social Worker
- New Haven, CT
National Provider Identifier
1407272446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8579
- Practice address
- 20 York Street
Yale-New Haven Psychiatric Hospital
New Haven, CT 06510 - Phone
- (203) 688-0279
- NPI assigned
- Mar 14, 2014
- Sex
- Female
- 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 | 8579 | CT | Primary |
Addresses
Primary practice location
20 York Street
Yale-New Haven Psychiatric Hospital
New Haven, CT 06510
Mailing address
22 Margo Cir
North Haven, CT 06473-1924
Phone (551) 265-3760
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8579 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1407272446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MARGO CIR",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064731924",
"telephone_number": "551-265-3760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 YORK STREET",
"address_2": "YALE-NEW HAVEN PSYCHIATRIC HOSPITAL",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "203-688-0279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RURAK",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "8579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.