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Deactivated NPI 1982168688 Deactivated / Inactive NPI Female Practitioner

Phetsamon Dilullo

Social Worker - Clinical • Windsor, CT

✓ Accepts Medicare Assignment Telehealth Available
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Phetsamon Dilullo has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 27, 2019
NPI Deactivation Date February 11, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

Professional Overview & Biography Verified Profile Summary

Phetsamon Dilullo was a registered Social Worker - Clinical practicing in Windsor, CT. Throughout an active medical career spanning 12 years, Phetsamon Dilullo provided care at the practice location at 32 MAPLE AVE until profile deactivation on 2019-02-11.

Phetsamon Dilullo was affiliated with Amherst Psychotherapy Practice Pc and accepted Medicare assignment . Telehealth and virtual consultation options were offered for eligible patients.

Historical Medicare Part B clinical services included psychotherapy, group psychotherapy. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

32 Maple Ave

Windsor, CT 060952922

Telephone 8609739171
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker - Clinical in Windsor, CT

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
19 Yrs +2.4 yrs vs City Avg
City Avg: 16.6 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
53 Specialists

Practicing in Windsor, CT (7959 Statewide)

Telehealth Adoption Rate
3.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
58.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dilullo (19 Years) 19 Yrs
Windsor Specialty Average (16.6 Years) 16.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90834 Psychotherapy, 45 minutes
70 12 $170.00 $78.38
90853 Group psychotherapy
51 11 $70.00 $21.29

Medical Specialties & State Licenses

Social Worker - Clinical Primary Specialty

NUCC Taxonomy Code: 1041C0700X

State License CT 010163

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Hospital & Practice Group Affiliations

Amherst Psychotherapy Practice Pc

48 N Pleasant St, Amherst, MA 010021758

Phone: 4132008024

Secondary Practice Locations

32 Maple Ave

Windsor, CT 060952922

Phone: 8609739171

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Jennine Gialopsos , LCSW, LADC

Social Worker - Clinical

NPI 1063500601

Licensed Clinical Social Worker, Licensed Alcohol and Drug Counselor

Patricia James , LCSW

Social Worker - Clinical

NPI 1164431698

Licensed Clinical Social Worker

Cherese Boyd

Social Worker - Clinical

NPI 1164986865
Dr. Daniel Weiss , PsyD

Psychologist - Clinical

NPI 1285764415

Doctor of Psychology (Psy.D.)

Jennifer Lewis , LCSW

Social Worker - Clinical

NPI 1376669648

Licensed Clinical Social Worker

Heath Hightower , MSW, LCSW, LICSW

Social Worker - Clinical

NPI 1578552626

Master of Social Work, Licensed Clinical Social Worker, Licensed Independent Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
📍
Updated Practice Location April 12, 2019

Registered at 32 MAPLE AVE, WINDSOR, CT 060952922 (Tel: 8609739171)

📍
Updated Business Mailing Address April 12, 2019

Registered at 32 MAPLE AVE, WINDSOR, CT 060952922 (Tel: 8609739171)

👤
Provider Name / Credentials Updated April 12, 2019

Recorded as PHETSAMON DILULLO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 12, 2019

Social Worker (License #010163 in CT)

⚠️
NPI Profile Deactivated February 11, 2019

Record deactivated on February 11, 2019

🟢
Initial NPI Registration & Enumeration January 27, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982168688
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 27, 2019
Last Update: April 12, 2019
Deactivation Date: February 11, 2019
Sole Proprietor: No

Mailing Address

32 Maple Ave

Windsor, CT 060952922

Phone: 8609739171

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.