Individual provider Active NPI

Kristen Tuttle, LCSWR

  • Clinical Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1669456653
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076859 Issued in NY
Practice address
1 Bushwick Rd Ste C
Poughkeepsie, NY 12603-3839
Phone
(914) 475-3041
NPI assigned
Dec 2, 2005
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 076859 NY Primary

Addresses

Primary practice location

1 Bushwick Rd Ste C
Poughkeepsie, NY 12603-3839

Mailing address

42 Gretna Rd
Pleasant Valley, NY 12569-6948
Phone (914) 475-3041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180906002738 NY Practitioner - Clinical Social Worker 8921358284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Gretna Rd
Pleasant Valley, NY 12569-6948

488 Freedom Plains Rd
Poughkeepsie, NY 12603-2689
Phone (914) 475-3041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076859NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Green NP in Adult Health PLLC CurrentSince Nov 24, 2024 Accepting new patients
Healthy Minds Counseling Services LCSW PLLC Clinical CurrentSince Aug 4, 2021 Accepting new patients

Locations

1 Bushwick Rd
Ste C
Poughkeepsie, NY 12603
Phone (845) 579-3435

488 Freedom Plains Rd
Poughkeepsie, NY 12603
Phone (845) 452-5151

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1669456653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 GRETNA RD",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125696948",
            "telephone_number": "914-475-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BUSHWICK RD STE C",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033839",
            "telephone_number": "914-475-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "KRISTEN",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.