Individual provider Active NPI

Rupa S Gandhi, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1811267826
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000620 Issued in CT
Practice address
22 Tompkins St
Waterbury, CT 06708-1496
Phone
(203) 754-5141
Fax
(201) 757-1198
NPI assigned
Jan 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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 000620 CT Primary

Addresses

Primary practice location

22 Tompkins St
Waterbury, CT 06708-1496

Mailing address

22 Tompkins St
Waterbury, CT 06708-1496
Phone (203) 754-5141

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

State licenses

LicenseStateTypeSpecialty
000620CTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1811267826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TOMPKINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081496",
            "telephone_number": "203-754-5141",
            "fax_number": "201-757-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TOMPKINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081496",
            "telephone_number": "203-754-5141",
            "fax_number": "201-757-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "RUPA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.