Portia Pendleton, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW4442 Issued in CT

Practice address

190 Westbrook Rd
Essex, CT 06426-1518

Phone

(860) 767-0147

Fax

(860) 767-0148

NPI assigned

Sep 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Portia Kimbis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Portia Pendleton, LCSW LLC.

  • Clinical Social Worker
  • Old Saybrook, CT
  • NPI 1285261156
  NPD Authorized official

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1104374230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WESTBROOK RD",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261518",
            "telephone_number": "860-767-0147",
            "fax_number": "860-767-0148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Hempstead St",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063206204",
            "country_code": "US",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "PORTIA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "LMSW4442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PORTIA",
            "last_name": "KIMBIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sommar Victoria Otfinoski
• Fernanda Hubner Page, PHARMACY THECNICIAN
• Eric Parnes, PT
• Pathways Center for Learning & Behavioral Health, LLC
• Peak Performance, Inc.
• Peter S. Dixon, M.D, P.C.
• Ellen H. Pfarr, LCSW
• Kristi Poehlmann, APRN
• Anne Procyk, N.D.
• Marybeth Pytlik Ellison, MD

• Clinical Social Worker in Essex, CT
• Providers in Essex, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.