Individual provider Active NPI

Paul J Bennett, LCSW

  • Clinical Social Worker
  • Torrington, CT
National Provider Identifier
1114164530
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007379 Issued in CT
Practice address
540 Litchfield St
Torrington, CT 06790-6679
Phone
(860) 496-6380
NPI assigned
Jan 8, 2009
Last updated
Sep 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 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 007379 CT Primary

Addresses

Primary practice location

540 Litchfield St
Torrington, CT 06790-6679

Mailing address

540 Litchfield St
Torrington, CT 06790-6679
Phone (860) 496-6380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241212001911 VA Practitioner - Clinical Social Worker 0244541084 Reassigns benefits to 1 organization
I20250807000364 DC Practitioner - Clinical Social Worker 0244541084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Psychiatrist, LLCGroup PAC ID 5597898981, 15 clinicians

Practice addresses (Care Compare)

12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3463
Phone (703) 596-4796

6565 Arlington Blvd
Suite 405
Falls Church, VA 22042-3013
Phone (703) 596-4796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Psychiatrist LLC CurrentSince Aug 15, 2024 Accepting new patients

Locations

8140 Ashton Ave
Ste 200
Manassas, VA 20109
Phone (703) 330-9933

12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796

12359 Sunrise Valley Dr
Ste 320
Reston, VA 20191
Phone (703) 596-4796

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.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1114164530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 LITCHFIELD ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906679",
            "telephone_number": "860-496-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LITCHFIELD ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906679",
            "telephone_number": "860-496-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.