Heather Costello, LCSW
Individual provider Active NPI Clinical Social Worker · Windsor Locks, CT
NPI 1174858633 · NPPES record last updated Jul 23, 2024
Key facts
- NPI
- 1174858633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 007131 (CT)
- Practice address
- 64 Oak Ridge Dr
Windsor Locks, CT 06096-2666 - Phone
- (860) 819-1528
- NPI assigned
- Oct 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
11 Sakrison Rd
Granby, CT 06035-1323
Phone (860) 819-1528
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091116000341 | CT | Practitioner - Clinical Social Worker | 5799823555 | Practice locations: Granby, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007131 | CT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007131 | CT | Yes |
Addresses
Primary practice location
64 Oak Ridge Dr
Windsor Locks, CT 06096-2666
Mailing address
64 Oak Ridge Dr
Windsor Locks, CT 06096-2666
Phone (860) 819-1528
Other names
- Heather Dobbert
Other providers in Windsor Locks, CT
- Chiropractic Health Centers, LLC
- Leisa Phillips Cleveland
- Lisa Ann Cloutier
- Connecticut CVS Pharmacy LLC
- Mona Copeland
- Amber Curran
- Marc Samuel Cutler
- Eastern Services & Camp Simon LLC
- Ayesha Ejaz
- Elegant, LLC.
All providers in Windsor Locks, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.