Courtney W. Augustine-Palmer, LMSW
Individual provider Active NPI Social Worker · Middletown, CT
NPI 1043737653 · NPPES record last updated Aug 24, 2017
Key facts
- NPI
- 1043737653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 3741 (CT)
- Practice address
- 196 Court St
Middletown, CT 06457-3302 - Phone
- (860) 985-5426
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211005000781 | CT | Practitioner - Clinical Social Worker | 4880092931 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3741 | CT | MD | Mental Health Counselor |
| 11598 | CT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Connection Inc. | Past | Accepting new patients | |
| The Connection Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3741 | CT | Yes |
Addresses
Primary practice location
196 Court St
Middletown, CT 06457-3302
Mailing address
100 Roscommon Dr Ste 203
Middletown, CT 06457-7558
Phone (860) 343-5500
Other providers in Middletown, CT
- Athena Middlesex, LLC
- Jacqueline Mary Atkinson
- Katherine Carol Attong-Jackson
- Nicole Christina Aucoin
- David Augenblick
- Akashdeep Aujla
- Tanya Azzaro
- Samuel Allan Babcock
- Jessica Marie Badichek
- Jessenia Baez
All providers in Middletown, CT · Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.