Healthcare Provider Details

I. General information

NPI: 1922535921
Provider Name (Legal Business Name): PIMPUTKAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 EAST AVE
NORWALK CT
06851-5020
US

IV. Provider business mailing address

91 EAST AVE
NORWALK CT
06851-5020
US

V. Phone/Fax

Practice location:
  • Phone: 203-286-4454
  • Fax:
Mailing address:
  • Phone: 203-286-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. CHAITALI SUDHEER PIMPUTKAR
Title or Position: OWNER AND PSYCHOTHERAPIST
Credential: LCSW
Phone: 203-286-4454