Individual provider Active NPI

Marie-Paule Lopez de Valdivia, LCSW

  • Clinical Social Worker
  • Stratford, CT
National Provider Identifier
1588044879
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008884 Issued in CT
Practice address
90 Fifth Ave
Stratford, CT 06615-7778
Phone
(203) 981-0113
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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 008884 CT Primary

Addresses

Primary practice location

90 Fifth Ave
Stratford, CT 06615-7778

Mailing address

90 Fifth Ave
Stratford, CT 06615-7778
Phone (203) 981-0113

Other names 1

  • Marie-Paule De Valdivia Other name

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

LicenseStateTypeSpecialty
008884CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1588044879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 FIFTH AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157778",
            "telephone_number": "203-981-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FIFTH AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157778",
            "telephone_number": "203-981-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ DE VALDIVIA",
        "first_name": "MARIE-PAULE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE-PAULE",
            "last_name": "DE VALDIVIA",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.