Individual provider Active NPI

Jonathan Wetherby Swift, L.C.S.W., PH.D

  • Clinical Social Worker
  • Madison, CT
National Provider Identifier
1811048002
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1821 Issued in CT
Practice address
588 Boston Post Rd
Suite East
Madison, CT 06443-3042
Phone
(203) 245-0062
Fax
(203) 245-9446
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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 1821 CT Primary

Addresses

Primary practice location

588 Boston Post Rd
Suite East
Madison, CT 06443-3042

Mailing address

588 Boston Post Rd
Suite East
Madison, CT 06443-3042
Phone (203) 245-0062

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1821CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1811048002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 BOSTON POST RD",
            "address_2": "SUITE EAST",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433042",
            "telephone_number": "203-245-0062",
            "fax_number": "203-245-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 BOSTON POST RD",
            "address_2": "SUITE EAST",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433042",
            "telephone_number": "203-245-0062",
            "fax_number": "203-245-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "JONATHAN",
        "middle_name": "WETHERBY",
        "name_prefix": "Dr.",
        "credential": "L.C.S.W., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "1821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.