Patricia C. Nietsch, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

30 Elizabeth Street
Lower Naugatuck Valley Parent Child Resource Center, in
Derby, CT 06418

Phone

(203) 954-0543

Fax

(203) 954-0544

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Fairwinds-Nantuckets Counseling CenterGroup PAC ID 7517997992, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fairwinds-Nantuckets Counseling Center

  • Community/Behavioral Health Agency
  • Nantucket, MA
  • NPI 1275621385
  Medicare reassignment Care Compare group NPD
• Family & Children'S Agency, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, CT
  • NPI 1417170879
  NPD
• Fairwinds-Nantucket'S Counseling Center, Inc

  • Developmental - Behavioral Pediatrics Physician
  • Nantucket, MA
  • NPI 1629537444
  NPD (past)

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1528316221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH STREET",
            "address_2": "LOWER NAUGATUCK VALLEY PARENT CHILD RESOURCE CENTER, IN",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "06418",
            "telephone_number": "203-954-0543",
            "fax_number": "203-954-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH STREET",
            "address_2": "LOWER NAUGATUCK VALLEY PARENT CHILD RESOURCE CENTER, IN",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "06418",
            "telephone_number": "203-954-0543",
            "fax_number": "203-954-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETSCH",
        "first_name": "PATRICIA",
        "middle_name": "C.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004039541",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neelima Kaushal, LLC
• Linda Nevins, APRN
• Calypse Asangbe Ngwasiri, M.D.
• Shauna-Kaye Nicholson, LCSW
• Abdelhameed Nienaa, MD
• Adambeke Nwozuzu, MD
• Karen O'Brien, L.C.S.W.
• Oec Derby LLC
• Jimin Oh, D.D.S
• Omowumi Funmilola Olarinmoye, MD

• Clinical Social Worker in Derby, CT
• Providers in Derby, 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 Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.