Individual provider Active NPI

Sheila A Owen, LCSW, LADC

  • Clinical Social Worker
  • North Haven, CT
National Provider Identifier
1194093864
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9076 Issued in CT
Practice address
16 Broadway
First Floor
North Haven, CT 06473
Phone
(203) 494-2824
Fax
(203) 230-0559
NPI assigned
Dec 8, 2011
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000705 CT
Clinical Social Worker 1041C0700X 9076 CT Primary

Addresses

Primary practice location

16 Broadway
First Floor
North Haven, CT 06473

Mailing address

16 Broadway
First Floor
North Haven, CT 06473
Phone (203) 494-2824

Other identifiers 3

IdentifierTypeStateIssuer
008003745MedicaidCT
004041000MedicaidCT
008038041MedicaidCT

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
I20170118001571 CT Practitioner - Clinical Social Worker 3779865290 Reassigns benefits to 2 organizations
Practice locations: North Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16 Broadway
FL 1
North Haven, CT 06473-2301
Phone (203) 494-2824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000705CTMDClinical Psychologist
9076CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc Clinical CurrentSince Feb 1, 2023 Accepting new patients
Margaliet Ligtenstein LLC Clinical CurrentSince Jan 1, 2022 Accepting new patients
Tricircle Corporation Addiction (Substance Use Disorder) CurrentSince Feb 21, 2022 Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

1 Evergreen Ave
Hamden, CT 06518
Phone (203) 248-8047

6 Way Rd
Middlefield, CT 06455
Phone (860) 349-7012

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1194093864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BROADWAY",
            "address_2": "FIRST FLOOR",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-494-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BROADWAY",
            "address_2": "FIRST FLOOR",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-494-2824",
            "fax_number": "203-230-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "SHEILA",
        "middle_name": "A",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000705",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041000",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008038041",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.