Individual provider Active NPI

Michael Westfall, LCSW

  • Clinical Social Worker
  • Manchester, CT
National Provider Identifier
1124141403
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006313 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 646-1222
Fax
(860) 647-6831
NPI assigned
Apr 9, 2007
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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 006313 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 646-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • 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
I20090915000013 CT Practitioner - Clinical Social Worker 5193871275 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006313CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Manchester Hospital, Inc. Clinical CurrentSince Nov 8, 2023 Accepting new patients
Eastern Connecticut Medical Professionals Foundation, Inc Past Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Clinical Past Accepting new patients

Locations

320 Main St
Manchester, CT 06040

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

Organizations & group practices 5

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1124141403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222",
            "fax_number": "860-647-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222",
            "fax_number": "860-647-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTFALL",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.