Active NPI
Mary Elizabeth Whalen
- Occupational Therapy Assistant
- Madison, CT
National Provider Identifier
1982488946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1425
- Practice address
- 1110 Durham Rd
Madison, CT 06443-1858 - Phone
- (203) 751-7182
- NPI assigned
- Aug 22, 2023
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1425 | CT | Primary |
Addresses
Primary practice location
1110 Durham Rd
Madison, CT 06443-1858
Mailing address
2 Short Beach Rd Unit 11
East Haven, CT 06512-3562
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 |
|---|---|---|---|
| 1425 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1982488946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SHORT BEACH RD UNIT 11",
"city": "EAST HAVEN",
"state": "CT",
"postal_code": "065123562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 DURHAM RD",
"city": "MADISON",
"state": "CT",
"postal_code": "064431858",
"telephone_number": "203-751-7182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHALEN",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "1425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.