Nicole Korth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

010792 Issued in CT

Practice address

560 Gaylord Mountain Rd
Hamden, CT 06518-1009

Phone

(860) 759-3554

NPI assigned

Dec 6, 2019

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nicole.korth.p1@direct.wheelerclinic.nextgenshare.com

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.

• Compassion Coherence LLP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wallingford, CT
  • NPI 1073354429
  Medicare reassignment NPD

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1205473410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAYLORD MOUNTAIN RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181009",
            "telephone_number": "860-759-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 GAYLORD MOUNTAIN RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181009",
            "telephone_number": "860-759-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTH",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "010792",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Koczak, DPT
• Robert Martin Koenig, PH.D.
• Roxanne Kohilakis, AU.D.
• Clara Elizabeth Kohrn
• Sandra Kraeuter Kops, PH.D., R.D., CD-N
• Jeremy Kortmansky, MD
• Marissa Michelle Kosh
• Alexandria Koukos, APRN, FNP-C
• Emma Belle Kravet, RN
• Kenneth Kregling, DPT

• Clinical Social Worker in Hamden, CT
• Providers in Hamden, 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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.