Individual provider Active NPI

Parker Mills, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1164958997
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009602 Issued in CT
Practice address
51 Broad St
Middletown, CT 06457-3204
Phone
(860) 358-3445
Fax
(860) 358-3403
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 009602 CT Primary

Addresses

Primary practice location

51 Broad St
Middletown, CT 06457-3204

Mailing address

51 Broad St
Middletown, CT 06457-3204
Phone (860) 358-3445

Other identifiers 1

IdentifierTypeStateIssuer
009602OtherCTCT DPH

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
I20170612000356 CT Practitioner - Clinical Social Worker 2769750033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

51 Broad St
Middletown, CT 06457-3204
Phone (860) 358-3401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009602CTMDClinical Social Worker
9602CTMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Apr 15, 2017 Accepting new patients
Middlesex Hospital CurrentSince Apr 15, 2017 Accepting new patients

Locations

51 Broad St
Middletown, CT 06457
Phone (860) 358-3401

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1164958997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BROAD ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573204",
            "telephone_number": "860-358-3445",
            "fax_number": "860-358-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BROAD ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573204",
            "telephone_number": "860-358-3445",
            "fax_number": "860-358-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "PARKER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT DPH",
            "identifier": "009602",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.