Individual provider Active NPI

Joan D. Cahill, LCSW

Clinical Social Worker
Southington, CT

National Provider Identifier

1083743488

Registry record updated Jul 8, 2007

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Southington, CT
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Clinical Social WorkerTaxonomy code 1041C0700X
License: 000271 Issued in CT
Practice address: 51 N Main St
Ste. 2 D
Southington, CT 06489-2537
Phone: (860) 628-3963
Fax: (860) 628-3966
NPI assigned: Mar 4, 2007
Last updated: Jul 8, 2007By the provider in NPPES
Sex: Female
Sole proprietor: Yes

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)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	000271	CT	Primary

Addresses

Primary practice location

51 N Main St
Ste. 2 D
Southington, CT 06489-2537

Mailing address

PO Box 401
Southington, CT 06489-0401
Phone (860) 628-3963

Other identifiers 15

Identifier	Type	State	Issuer
00387	Other	CT	EAP PID #
073423	Other	CT	VALUE OPTIONS PID #
0004264841	Other	CT	AETNA PID #
2212025	Other	CT	AETNA EAP PID #
140000271CT02	Other	CT	PID #
6257312	Other	CT	UHC PID #
6257312	Other	CT	UBH PID #
2212025	Other	CT	AETNA
426484	Other	CT	AETNA USHC
919201	Other	CT	PACIFIC CARE PID #
170616	Other		MHN PID #
192907	Other	CT	COMPSYCHE PID #
4264841	Other	CT	PID MAGELLAN #
42664	Other	CT	PID #
P398863	Other	CT	PID OXFORD #

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 ID	State	Provider type	PAC ID	Details
I20081124000115	CT	Practitioner - Clinical Social Worker	2567522386	Practice locations: Southington, CT

National Provider Directory

Medicare enrollment (NPD): Enrolled

State licenses

License	State	Type	Specialty
000271	CT	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Melina Mansour LLC		Past	Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Melina Mansour LLC
- Marriage & Family Therapist
- Southington, CT
- NPI 1629493036
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083743488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 401",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064890401",
            "telephone_number": "860-628-3963",
            "fax_number": "860-628-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N MAIN ST",
            "address_2": "STE. 2 D",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892537",
            "telephone_number": "860-628-3963",
            "fax_number": "860-628-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "JOAN",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAP PID #",
            "identifier": "00387",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PID #",
            "identifier": "073423",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PID #",
            "identifier": "0004264841",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA EAP PID #",
            "identifier": "2212025",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PID #",
            "identifier": "140000271CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PID #",
            "identifier": "6257312",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH PID #",
            "identifier": "6257312",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2212025",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "426484",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC CARE PID #",
            "identifier": "919201",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PID #",
            "identifier": "170616",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCHE PID #",
            "identifier": "192907",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PID MAGELLAN #",
            "identifier": "4264841",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PID #",
            "identifier": "42664",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PID OXFORD #",
            "identifier": "P398863",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.