Justin Andrew Rogala, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006512 Issued in CT

Practice address

34 Park St
Office 215 Connecticut Mental Health Center
New Haven, CT 06519-1109

Phone

(203) 974-7044

Fax

(203) 974-7322

NPI assigned

Jan 31, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Etherapy of Connecticut, LLC

  • Clinical Social Worker
  • Wallingford, CT
  • NPI 1851640163
  NPD Authorized official
• State of Connecticut

  dba Connecticut Mental Health Center

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434
  NPD (past)

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1205013315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "address_2": "OFFICE 215 CONNECTICUT MENTAL HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "203-974-7044",
            "fax_number": "203-974-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "address_2": "OFFICE 215 CONNECTICUT MENTAL HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "203-974-7044",
            "fax_number": "203-974-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGALA",
        "first_name": "JUSTIN",
        "middle_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nayeli Rodulfo-Zayas, M.D.
• Rozalyn Levine Rodwin, M.D.
• Davis Rigby Roe, PA-C
• Teresa Roehrich, LADC
• Elizabeth Mae Roessler, PA
• Sandra B Roger
• Joyce A Rogers
• Katie Rogers, PA
• Ronald Legrand Rogers, MD
• Ryan Christian Rogers, PA-C

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.