Richard Povilaitis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CT0002715 Issued in CT

Practice address

12 Woodside Ave
Middlebury, CT 06762-2822

Phone

(203) 598-0552

NPI assigned

May 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waterbury Hospital

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1184615114
  NPD (past)

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932314903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WOODSIDE AVE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622822",
            "telephone_number": "203-598-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WOODSIDE AVE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622822",
            "telephone_number": "203-598-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVILAITIS",
        "first_name": "RICHARD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "CT0002715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11244097",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CT002715",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles A Polnitsky, MD
• Katherine Leigh Pomeroy, M.A.,M.S.,L.M.F.T.
• Christine Elizabeth Pond, LPC
• Shaquasa Porter
• Amanda Potts, PA-C, MHS
• James T Prado, D.C.
• Preferred Home Care, LLC
• Marissa Primiano, LPC
• Princess Corset & Lingerie Shop II, LLC
• Ana Quintana Villafuerte, FNP-C

• Clinical Social Worker in Middlebury, CT
• Providers in Middlebury, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.