Individual provider Active NPI

Shane Murphy, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1104162122
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8233 Issued in CT
Practice address
18 Oneco St Ste 3
Norwich, CT 06360-3440
Phone
(860) 961-6252
Fax
(860) 556-9147
NPI assigned
Dec 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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 008233 CT
Clinical Social Worker 1041C0700X 8233 CT Primary

Addresses

Primary practice location

18 Oneco St Ste 3
Norwich, CT 06360-3440

Mailing address

18 Oneco St Ste 3
Norwich, CT 06360-3440
Phone (860) 961-6252

Other identifiers 1

IdentifierTypeStateIssuer
008043829MedicaidCT

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
I20141014002272 CT Practitioner - Clinical Social Worker 4486875507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Oneco St
Suite 3
Norwich, CT 06360-3440
Phone (860) 961-6252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8233CTMDPharmacist
008233CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Perspective Counseling Services LLC Clinical CurrentSince Apr 20, 2020 Accepting new patients

Locations

18 Oneco St
Ste 3
Norwich, CT 06360
Phone (860) 303-3172

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": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1104162122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ONECO ST STE 3",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063603440",
            "telephone_number": "860-961-6252",
            "fax_number": "860-556-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ONECO ST STE 3",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063603440",
            "telephone_number": "860-961-6252",
            "fax_number": "860-556-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "SHANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-19",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "008233",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008043829",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.