Individual provider Active NPI

Christine Palluotto Gaudio, LCSW

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1053450841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000502 Issued in CT
Practice address
68 South Main Street
West Hartford, CT 06107
Phone
(860) 561-0819
Fax
(860) 561-6184
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 000502 CT Primary

Addresses

Primary practice location

68 South Main Street
West Hartford, CT 06107

Mailing address

68 South Main Street
West Hartford, CT 06107
Phone (860) 561-0819

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
I20070511000399 CT Practitioner - Clinical Social Worker 9234236027 Practice locations: West Hartford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

68 S Main St
West Hartford, CT 06107-2445
Phone (860) 561-0819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000502CTMDAudiologist
502CTMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Louis Graff LLC PastSince Jul 3, 2014 Accepting new patients
Jill Shalan, PHD, PLLC PastSince Feb 4, 2018 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053450841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 SOUTH MAIN STREET",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06107",
            "telephone_number": "860-561-0819",
            "fax_number": "860-561-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 SOUTH MAIN STREET",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06107",
            "telephone_number": "860-561-0819",
            "fax_number": "860-561-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDIO",
        "first_name": "CHRISTINE",
        "middle_name": "PALLUOTTO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.