Individual provider Active NPI

Ellen Turner Lacko, LCSW

  • Clinical Social Worker
  • Bethel, CT
National Provider Identifier
1174947147
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003021 Issued in CT
Practice address
14 E Brook CT
Bethel, CT 06801-1601
Phone
(203) 733-5529
NPI assigned
Feb 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 003021 CT Primary

Addresses

Primary practice location

14 E Brook CT
Bethel, CT 06801-1601

Mailing address

14 E Brook CT
Bethel, CT 06801-1601
Phone (203) 733-5529

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
I20251112001509 CT Practitioner - Clinical Social Worker 5597256156 Practice locations: Bethel, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14 E Brook CT
Bethel, CT 06801-1601
Phone (203) 733-5529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003021CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellen T. Lacko,MSW,LCSW,LLC Clinical Past Accepting new patients

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": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1174947147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E BROOK CT",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011601",
            "telephone_number": "203-733-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E BROOK CT",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011601",
            "telephone_number": "203-733-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKO",
        "first_name": "ELLEN",
        "middle_name": "TURNER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

Verify at the official NPI Registry.