Individual provider Active NPI

Cristina Eleanor Zurlis, LCSW

  • Clinical Social Worker
  • Wallingford, CT
National Provider Identifier
1487128484
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010439 Issued in CT
Practice address
17 Sorrento Rd
Wallingford, CT 06492-4857
Phone
(203) 623-6326
NPI assigned
Jan 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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 010439 CT Primary

Addresses

Primary practice location

17 Sorrento Rd
Wallingford, CT 06492-4857

Mailing address

17 Sorrento Rd
Wallingford, CT 06492-4857
Phone (203) 623-6326

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
010439CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Seasons Wellness Center, LLC Clinical CurrentSince Sep 8, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1487128484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SORRENTO RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924857",
            "telephone_number": "203-623-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SORRENTO RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924857",
            "telephone_number": "203-623-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZURLIS",
        "first_name": "CRISTINA",
        "middle_name": "ELEANOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.