Individual provider Active NPI

Melinda Challman, LCSW

  • Clinical Social Worker
  • Plantsville, CT
National Provider Identifier
1144006255
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58.012875 Issued in CT
Practice address
341 West St Unit B
Plantsville, CT 06479-1140
Phone
(475) 216-6264
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 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 58.012875 CT Primary

Addresses

Primary practice location

341 West St Unit B
Plantsville, CT 06479-1140

Mailing address

341 West St Unit B
Plantsville, CT 06479-1140
Phone (475) 216-6264

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
I20240417004236 CT Practitioner - Clinical Social Worker 4981043353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58.012875CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Mar 11, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Mar 11, 2024 Accepting new patients

Locations

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

Interoperability endpoints

  • Direct secure messaging: melinda.challman.1@28623.direct.athenahealth.com

Organizations & group practices 2

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": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1144006255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WEST ST UNIT B",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791140",
            "telephone_number": "475-216-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 WEST ST UNIT B",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791140",
            "telephone_number": "475-216-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALLMAN",
        "first_name": "MELINDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.012875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantsville, CT

Sources for this page

Verify at the official NPI Registry.