Individual provider Active NPI

Mary P Ziller, LCSW

  • Clinical Social Worker
  • Fairfield, CT
National Provider Identifier
1477611317
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002905 Issued in CT
Practice address
365 Buena Vista Rd
Fairfield, CT 06825-1620
Phone
(203) 394-7189
Fax
(203) 330-0896
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 002905 CT Primary

Addresses

Primary practice location

365 Buena Vista Rd
Fairfield, CT 06825-1620

Mailing address

365 Buena Vista Rd
Fairfield, CT 06825-1620
Phone (203) 394-7189

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
002905CTMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: mary.ziller@xdr.hhchealthdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477611317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 BUENA VISTA RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251620",
            "telephone_number": "203-394-7189",
            "fax_number": "203-330-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 BUENA VISTA RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251620",
            "telephone_number": "203-394-7189",
            "fax_number": "203-330-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZILLER",
        "first_name": "MARY",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.