Individual provider Active NPI

Mary Painter, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1912049610
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003423 Issued in CT
Practice address
141 E Main St
Waterbury, CT 06702-2310
Phone
(203) 574-9000
Fax
(203) 574-9006
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 003423 CT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000447 CT

Addresses

Primary practice location

141 E Main St
Waterbury, CT 06702-2310

Mailing address

141 E Main St
Waterbury, CT 06702-2310
Phone (203) 574-9000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000447CTMDPodiatrist
003423CTMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1912049610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINTER",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003423",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000447",
            "primary": false
        }
    ],
    "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 May 21, 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.