Individual provider Active NPI

Emily Brede, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1124673520
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11841 Issued in CT
Practice address
43 Woodland St
Hartford, CT 06105-2363
Phone
(860) 793-3500
NPI assigned
Aug 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4537 CT
Clinical Social Worker 1041C0700X 11841 CT Primary

Addresses

Primary practice location

43 Woodland St
Hartford, CT 06105-2363

Mailing address

43 Woodland St
Hartford, CT 06105-2363
Phone (860) 793-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • 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
I20211204000083 CT Practitioner - Clinical Social Worker 2567852684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mellahealth LLCGroup PAC ID 9032528658, 23 clinicians
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

125 Lasalle Rd
Suite 300
West Hartford, CT 06107-2311
Phone (860) 810-0587

43 Woodland St
Hartford, CT 06105-2363
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11841CTMDDentist
4537CTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mellahealth LLC Clinical CurrentSince Apr 1, 2022 Accepting new patients
Ruby Psychiatric Services, PLLC PastSince Apr 1, 2022 Accepting new patients

Locations

125 Lasalle Rd
Ste 300
West Hartford, CT 06107
Phone (860) 342-8192

Interoperability endpoints

  • Direct secure messaging: emily.brede.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1124673520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "860-793-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDE",
        "first_name": "EMILY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-03",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "4537",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.