Individual provider Active NPI

Carol L Mandigo, LICSW

  • Clinical Social Worker
  • Concord, NH
National Provider Identifier
1164690228
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
372 Issued in NH
Practice address
6 S State St
Concord, NH 03301-3761
Phone
(603) 228-3862
Fax
(603) 226-0073
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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 372 NH Primary

Addresses

Primary practice location

6 S State St
Concord, NH 03301-3761

Mailing address

6 S State St
Concord, NH 03301-3761
Phone (603) 228-3862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080421000461 NH Practitioner - Clinical Social Worker 6507944279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
372NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carol L Mandigo Licsw LLC CurrentSince Sep 4, 2018 Accepting new patients

Locations

75 S Main St
Unit 7
Concord, NH 03301

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.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1164690228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 S STATE ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013761",
            "telephone_number": "603-228-3862",
            "fax_number": "603-226-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 S STATE ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013761",
            "telephone_number": "603-228-3862",
            "fax_number": "603-226-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIGO",
        "first_name": "CAROL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.