Individual provider Active NPI

Nancy Jean Wohlrabe, LCSW

  • Clinical Social Worker
  • East Berlin, CT
National Provider Identifier
1124244355
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008816 Issued in IL
Practice address
1224 Mill St Ste B001
East Berlin, CT 06023-1166
Phone
(847) 245-7939
NPI assigned
Apr 17, 2007
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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 149008816 IL Primary

Addresses

Primary practice location

1224 Mill St Ste B001
East Berlin, CT 06023-1166

Mailing address

1224 Mill St Ste B001
East Berlin, CT 06023-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149008816ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Journey Therapy, PLLC CurrentSince Jan 10, 2024 Accepting new patients

Locations

1224 Mill St
Ste B001
East Berlin, CT 06023
Phone (847) 245-7939

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1124244355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 MILL ST STE B001",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 MILL ST STE B001",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231166",
            "telephone_number": "847-245-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLRABE",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Berlin, CT

Sources for this page

Verify at the official NPI Registry.