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Kimberly L Beauregard, LCSW

Individual provider Active NPI Social Worker · East Hartford, CT

NPI 1053346510 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1053346510
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
005411 (CT)
Practice address
281 Main St
East Hartford, CT 06118-1823
Phone
(860) 569-5900
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
005411CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alcohol & Drug Recovery Centers, Inc Current Accepting new patients
Intercommunity, Inc. Current Accepting new patients

Locations

16 Coventry St
Hartford, CT 06112
Phone (860) 714-3701

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 005411 CT Yes

Addresses

Primary practice location

281 Main St
East Hartford, CT 06118-1823

Mailing address

281 Main St
East Hartford, CT 06118-1823
Phone (860) 569-5900

Other providers in East Hartford, CT

All providers in East Hartford, CT · Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.