Individual provider Active NPI

Lindsey Patricia Gonnelli, BA

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1073144101
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58.012851 Issued in CT
Practice address
43 Woodland St
Hartford, CT 06105-2363
Phone
(860) 793-3500
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 58.012851 CT Primary

Addresses

Primary practice location

43 Woodland St
Hartford, CT 06105-2363

Mailing address

43 Woodland St
Hartford, CT 06105-2363
Phone (860) 793-3500

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
I20230530001425 CT Practitioner - Clinical Social Worker 1355708835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

43 Woodland St
Hartford, CT 06105-2363
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
58.012851CTMDClinical Social Worker
12851CTMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lindsey.massicotte.p1@direct.wheelerclinic.nextgenshare.com

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": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1073144101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "860-793-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONNELLI",
        "first_name": "LINDSEY",
        "middle_name": "PATRICIA",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.012851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.