Charlston Bath, LMSW
Individual provider Active NPI Social Worker · Wallingford, CT
NPI 1487416855 · NPPES record last updated Jan 30, 2024
Key facts
- NPI
- 1487416855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 122175 (NY)
- Practice address
- 50 Jodi Dr
Wallingford, CT 06492-2847 - Phone
- (203) 671-7843
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122175 | NY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 122175 | NY | Yes |
Addresses
Primary practice location
50 Jodi Dr
Wallingford, CT 06492-2847
Mailing address
50 Jodi Dr
Wallingford, CT 06492-2847
Other providers in Wallingford, CT
- Breanna Lynn Barra
- Melissa Barra
- Kristie Barry-Ayres
- Michele Palmucci Barry
- Matthew Basile
- Morgan Heather Bau
- Erica Bauer
- Sarah Baum
- Carolyn S. Beale
- Gary Beard
All providers in Wallingford, CT · Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.