Allyson Leary Modica, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006131 Issued in CT

Practice address

31 Westmont Dr
Waterbury, CT 06708-2420

Phone

(904) 382-9117

NPI assigned

Mar 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Medicare reassignment NPD
• Holistic Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterbury, CT
  • NPI 1871983239
  NPD (past)
• New Beginnings Counseling LLC

  • Clinical Social Worker
  • Middlebury, CT
  • NPI 1568094902
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1043289762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WESTMONT DR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082420",
            "telephone_number": "904-382-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WESTMONT DR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082420",
            "telephone_number": "904-382-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODICA",
        "first_name": "ALLYSON",
        "middle_name": "LEARY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Kennedy Mitchell, O.D.
• Joanne Mitchell, RDH
• Katie Mitchell, CRNA
• Jeannette Z Mitrukiewicz, LCSW
• James Mobilio, MA,BA,
• Erika Mogrovejo, DDS
• Enas Mohammad, MFT
• Ibrahim Mohammed, MD
• Mitchell Ross Mohr, MD
• Jazmin Molina, LADC

• Clinical Social Worker in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.