Active NPI
Julia Israelski, LCSW
- Clinical Social Worker
- Norwich, CT
National Provider Identifier
1114175874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 007226
- Practice address
- 47 Town St
Norwich, CT 06360-2315 - Phone
- (860) 892-7042
- NPI assigned
- Sep 5, 2008
- Last updated
- Mar 31, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0760001 | NY | |
| Clinical Social Worker | 1041C0700X | 007226 | CT | Primary |
Addresses
Primary practice location
47 Town St
Norwich, CT 06360-2315
Mailing address
47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235942 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 15, 2023 through Dec 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0760001 | NY | MD | Social Worker |
| 7226 | CT | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269993600000",
"number": "1114175874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "860-892-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "860-892-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISRAELSKI",
"first_name": "JULIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2010-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "0760001",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "007226",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235942",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.