Individual provider Active NPI

Eleonora Miller, LCSW

  • Clinical Social Worker
  • Hamden, CT
National Provider Identifier
1043495195
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007838 Issued in CT
Practice address
1844 Whitney Ave
Hamden, CT 06517-1400
Phone
(203) 407-1310
Fax
(203) 407-1309
NPI assigned
Jan 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007838 CT Primary

Addresses

Primary practice location

1844 Whitney Ave
Hamden, CT 06517-1400

Mailing address

988 New London Tpke
Glastonbury, CT 06033-5312
Phone (860) 262-4125

Other identifiers 3

IdentifierTypeStateIssuer
008003745MedicaidCT
008057039MedicaidCT
004041000MedicaidCT

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
I20150629002343 CT Practitioner - Clinical Social Worker 3779895065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1844 Whitney Ave
Hamden, CT 06517-1400
Phone (203) 407-1310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007838CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater New Haven Counseling and Family Therapy Center, LLP Clinical CurrentSince Jul 13, 2023 Accepting new patients

Locations

1844 Whitney Ave
Hamden, CT 06517
Phone (203) 407-1310

1844 Whitney Ave
Ste 2
Hamden, CT 06517
Phone (203) 407-1310

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": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1043495195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 NEW LONDON TPKE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060335312",
            "telephone_number": "860-262-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065171400",
            "telephone_number": "203-407-1310",
            "fax_number": "203-407-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELEONORA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008057039",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041000",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.