Active NPI
Ashleigh Lauren Pettit, LCSW
- Clinical Social Worker
- Orange, CT
National Provider Identifier
1861151714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11882
- Practice address
- 200 Edison Rd
Orange, CT 06477-3602 - Phone
- (203) 508-7834
- NPI assigned
- Dec 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11882 | CT | Primary |
Addresses
Primary practice location
200 Edison Rd
Orange, CT 06477-3602
Mailing address
373 Central Ave # 2
New Haven, CT 06515-2207
Phone (870) 736-5022
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11882 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1861151714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 CENTRAL AVE # 2",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065152207",
"telephone_number": "870-736-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 EDISON RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773602",
"telephone_number": "203-508-7834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "ASHLEIGH",
"middle_name": "LAUREN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-08",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "11882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.