Organization Active NPI

Boris Enowitch Ms LCSW LLC

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1073248340
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BORIS ENOWITCH MS LCSW LLC
Practice address
81 S Main St
West Hartford, CT 06107-2405
Phone
(860) 805-6386
NPI assigned
Jul 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Mr. Boris Enowitch, MS, LCSWNPI 1891163127
Title
Clinical Social Worker
Phone
(860) 805-6386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

81 S Main St
West Hartford, CT 06107-2405

Mailing address

12 Crossroads PLZ Unit 370093
West Hartford, CT 06137-7705
Phone (860) 805-6386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241120003739 CT Part B Supplier - Clinic/Group Practice 6305385527 Receives reassigned benefits from 1 practitioner
Practice locations: West Hartford, CT

National Provider Directory

National Provider Directory

Locations

12 Crossroads Plz
Unit 370093
West Hartford, CT 06137

309 N Main St
West Hartford, CT 06117
Phone (860) 216-2007

81 S Main St
West Hartford, CT 06107
Phone (860) 521-4044

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1073248340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CROSSROADS PLZ UNIT 370093",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061377705",
            "telephone_number": "860-805-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 S MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072405",
            "telephone_number": "860-805-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORIS ENOWITCH MS LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "ENOWITCH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "860-805-6386",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.