Active NPI
Mary Chutjian, LCSW
- Clinical Social Worker
- Pawcatuck, CT
National Provider Identifier
1972845097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 000843
- Practice address
- 105 Asher Ave
Pawcatuck, CT 06379-1715 - Phone
- (860) 599-1936
- NPI assigned
- Mar 27, 2013
- Last updated
- Mar 27, 2013
- 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 | 000843 | CT | Primary |
Addresses
Primary practice location
105 Asher Ave
Pawcatuck, CT 06379-1715
Mailing address
20 York St
New Haven, CT 06510
Phone (860) 599-1936
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 |
|---|---|---|---|
| 000843 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1972845097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 YORK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "860-599-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ASHER AVE",
"city": "PAWCATUCK",
"state": "CT",
"postal_code": "063791715",
"telephone_number": "860-599-1936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUTJIAN",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-27",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "000843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pawcatuck, CT
- Katherine Anne Chesson, MSW, LICSW
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc. (West Vine Elementary)
- Child and Family Agency of Southeastern Connecticut, Inc. (Stonington High School)
- Clarisse D. Clemons Ferrara, MD
- Sean Andrew Colsen, DPM
- Vickie Lou Cummings, MS
- Dynamic Physical Therapy LLC
- Mercy Etzel, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.