Active NPI
Jacqueline Vaccari Keating
- Clinical Social Worker
- Mansfield Center, CT
National Provider Identifier
1124576863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 7B Ledgebrook Dr
Mansfield Center, CT 06250-1664 - Phone
- (860) 456-0038
- Fax
- (860) 456-8765
- NPI assigned
- Sep 12, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
7B Ledgebrook Dr
Mansfield Center, CT 06250-1664
Mailing address
2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522
Other practice location 1
444 Center St
Manchester, CT 06040-3926
Phone (860) 646-3888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Resources, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Windsor, CT
- NPI 1215979810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1124576863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WATERSIDE XING STE 401",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951588",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7B LEDGEBROOK DR",
"city": "MANSFIELD CENTER",
"state": "CT",
"postal_code": "062501664",
"telephone_number": "860-456-0038",
"fax_number": "860-456-8765"
}
],
"practiceLocations": [
{
"address_1": "444 Center St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "CT",
"postal_code": "060403926",
"country_code": "US",
"telephone_number": "860-646-3888",
"fax_number": "860-645-4132",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEATING",
"first_name": "JACQUELINE",
"middle_name": "VACCARI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield Center, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.