Paul J Bennett, LCSW
Individual provider Active NPI Clinical Social Worker · Torrington, CT
NPI 1114164530 · NPPES record last updated Sep 30, 2011
Key facts
- NPI
- 1114164530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 007379 (CT)
- Practice address
- 540 Litchfield St
Torrington, CT 06790-6679 - Phone
- (860) 496-6380
- NPI assigned
- Jan 8, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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, LLC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241212001911 | VA | Practitioner - Clinical Social Worker | 0244541084 | Reassigns benefits to 1 organization |
| I20250807000364 | DC | Practitioner - Clinical Social Worker | 0244541084 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007379 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Psychiatrist LLC | Current |
Accepting new patients |
Locations
8140 Ashton Ave
Ste 200
Manassas, VA 20109
Phone (703) 330-9933
12359 Sunrise Valley Dr
Ste 320
Reston, VA 20191
Phone (703) 596-4796
12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007379 | CT | Yes |
Addresses
Primary practice location
540 Litchfield St
Torrington, CT 06790-6679
Mailing address
540 Litchfield St
Torrington, CT 06790-6679
Phone (860) 496-6380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235918 | Medicaid | CT |
Other providers in Torrington, CT
- Gary Thomas Beecher
- Christina Bell
- Kristin Belter
- Mariah Benjamin
- Sara Benjamin
- Breanna M Berg
- Rachel B Berg
- Avram Simeon Berger
- Ronald O Berger
- Cherly Berglewicz
All providers in Torrington, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.