NPIMap

Organization Active NPI

Revision Studio LLC Therapy and Counseling Services

  • Clinical Social Worker
  • Old Greenwich, CT
National Provider Identifier
1841639556
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004269 Issued in CT
Legal business name
REVISION STUDIO LLC THERAPY AND COUNSELING SERVICES
Practice address
3 West End Avenue
Old Greenwich, CT 06870-9203
Phone
(203) 274-4284
NPI assigned
Jun 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Authorized official

Name
Ms. Judith Deborah Croen, LCSW
Title
Owner
Phone
(203) 274-4284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 004269 CT Primary

Addresses

Primary practice location

3 West End Avenue
Old Greenwich, CT 06870-9203

Mailing address

P.O. Box 172
Old Greenwich, CT 06870-9203
Phone (203) 274-4284

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1841639556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 172",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068709203",
            "telephone_number": "203-274-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEST END AVENUE",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068709203",
            "telephone_number": "203-274-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVISION STUDIO LLC THERAPY AND COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "CROEN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-274-4284",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.