Individual provider Active NPI

Leslie Pollack, MSW, LCSW

  • Clinical Social Worker
  • Hamden, CT
National Provider Identifier
1104847201
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW1287 Issued in CT
Practice address
295 Washington Ave.
Suite 9
Hamden, CT 06518-3025
Phone
(203) 287-8227
Fax
(203) 287-9502
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW1287 CT Primary

Addresses

Primary practice location

295 Washington Ave.
Suite 9
Hamden, CT 06518-3025

Mailing address

295 Washington Ave.
Suite 9
Hamden, CT 06518-3025
Phone (203) 287-8227

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
I20070621000090 CT Practitioner - Clinical Social Worker 3173528155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Laurel Health Services LLCGroup PAC ID 4284639261, 3 clinicians

Practice addresses (Care Compare)

295 Washington Ave
Suite 9
Hamden, CT 06518-3025
Phone (203) 287-8227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW1287CTMDClinical Social Worker
1287CTMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Counseling and Addiction Services LLC CurrentSince Apr 28, 2024 Accepting new patients

Locations

295 Washington Ave
Ste 9
Hamden, CT 06518
Phone (203) 287-8227

Organizations & group practices 2

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1104847201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 WASHINGTON AVE.",
            "address_2": "SUITE 9",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183025",
            "telephone_number": "203-287-8227",
            "fax_number": "203-287-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 WASHINGTON AVE.",
            "address_2": "SUITE 9",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183025",
            "telephone_number": "203-287-8227",
            "fax_number": "203-287-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "LCSW1287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.