Neil Canavan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005667 Issued in CT

Practice address

567 Vauxhall Street Ext
Waterford, CT 06385-4330

Phone

(860) 599-2348

NPI assigned

Jan 19, 2007

Last updated

Nov 20, 2012By the provider in NPPES

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.

• Orthopedic Physical Therapy of Southern New England LLC

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  • NPI 1043488059
  NPD (past)
• Select Behavioral Health, LLC

  • Psychiatry Physician
  • Norwich, CT
  • NPI 1609941731

  Clinical

  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1205989654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT STE 314",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854341",
            "telephone_number": "860-599-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854330",
            "telephone_number": "860-599-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "NEIL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Mazyck Brown, BCBA
• Warren Booth Burrows II, M.D.
• Jacqueline Byrne, PT, DPT
• Ellen Rountree Calkins, MSW
• Camera Counseling, LLC
• Sarah Canavan, MD
• Careco Holdings LLC
• Careco Medical, Inc.
• Careco Shoreline Inc
• Christopher R Carlson, PH.D.

• Clinical Social Worker in Waterford, CT
• Providers in Waterford, 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 Nov 20, 2012; 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.