Edwin G Taetsch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9037 Issued in CT

Practice address

21 Montauk Ave
New London, CT 06320-4906

Phone

(860) 439-6400

NPI assigned

Jul 26, 2006

Last updated

Dec 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Clinical Social Worker

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwin.taetsch.1@32885.direct.athenahealth.com

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.

• Connecticut Behavioral Health Assoc, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1629158126

  Clinical

  Medicare reassignment Care Compare group NPD
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)
• Compass Health, Inc

  dba Compass Health Network

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494

  Clinical

  NPD (past)
• Florida Therapy Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1407427800
  NPD (past)
• Life Management of NW FL, Inc.

  • Psychiatry Physician
  • Port St Joe, FL
  • NPI 1316977515
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1164445581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-439-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-439-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAETSCH",
        "first_name": "EDWIN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002025562",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469004813",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200912137",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008065427",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith L Swift, RN, CDE
• Aman Syed, DDS
• Shakil Uddin Syed, DDS
• Marc Steeve Sylvain, LPC-A
• Magdalena Szutowska, D.O.
• Rhondie Tait, PH.D.
• Amarilis Talavera-Briggs, M.D.
• Talk and Play, LLC.
• Cullen Michael Taplin
• Julia Tarbox, RD

• Clinical Social Worker in New London, CT
• Providers in New London, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.