Individual provider Active NPI

Janay Gonzales, LCSW

  • Clinical Social Worker
  • Mansfield Center, CT
National Provider Identifier
1033776828
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11511 Issued in CT
Practice address
140 N Frontage Rd
Mansfield Center, CT 06250-1648
Phone
(860) 456-2261
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4555 CT
Clinical Social Worker 1041C0700X 11511 CT Primary

Addresses

Primary practice location

140 N Frontage Rd
Mansfield Center, CT 06250-1648

Mailing address

PO Box 407
Willimantic, CT 06226-0407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220902002068 CT Practitioner - Clinical Social Worker 9234513631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Services IncGroup PAC ID 8426042698, 31 clinicians

Practice addresses (Care Compare)

140 N Frontage Rd
Mansfield Center, CT 06250-9998
Phone (860) 456-2261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4555CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Services Inc CurrentSince Aug 15, 2022 Accepting new patients

Locations

140 N Frontage Rd
Mansfield Ctr, CT 06250
Phone (860) 456-2261

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1033776828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062260407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N FRONTAGE RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501648",
            "telephone_number": "860-456-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JANAY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4555",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield Center, CT

Sources for this page

Verify at the official NPI Registry.