Individual provider Active NPI

Pearlene Martell, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1174748040
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004265 Issued in CT
Practice address
2550 Main St
Hartford, CT 06120-1936
Phone
(860) 548-0101
Fax
(860) 524-7781
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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 004265 CT Primary

Addresses

Primary practice location

2550 Main St
Hartford, CT 06120-1936

Mailing address

2550 Main St
Hartford, CT 06120-1936
Phone (860) 548-0101

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
I20100512001048 CT Practitioner - Clinical Social Worker 8527196542 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004265CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Manchester Hospital, Inc. CurrentSince Mar 25, 2024 Accepting new patients
Prospect Manchester Hospital, Inc. CurrentSince Mar 25, 2024 Accepting new patients
Hartford Community Mental Health Center Inc. PastSince Jul 10, 2011 Accepting new patients
Eastern Connecticut Medical Professionals Foundation, Inc Past Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

150 N Main St
Manchester, CT 06042
Phone (860) 533-3434

2600 Tamarack Ave
South Windsor, CT 06074
Phone (860) 872-0501

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

Organizations & group practices 6

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1174748040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MAIN ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061201936",
            "telephone_number": "860-548-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MAIN ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061201936",
            "telephone_number": "860-548-0101",
            "fax_number": "860-524-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "PEARLENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.