Active NPI
Sandra R Rousseau-Bicknell, LCSW
- Clinical Social Worker
- Middletown, CT
National Provider Identifier
1215005236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005526
- Practice address
- Dutton Home Silver St
River Valley Services
Middletown, CT 06457 - Phone
- (860) 262-5358
- Fax
- (860) 262-5850
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005526 | CT | Primary |
Addresses
Primary practice location
Dutton Home Silver St
River Valley Services
Middletown, CT 06457
Mailing address
Dutton Home Silver St PO Box 351
River Valley Services
Middletown, CT 06457
Phone (860) 262-5358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005526 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186099200000",
"number": "1215005236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DUTTON HOME SILVER ST PO BOX 351",
"address_2": "RIVER VALLEY SERVICES",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06457",
"telephone_number": "860-262-5358",
"fax_number": "860-262-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DUTTON HOME SILVER ST",
"address_2": "RIVER VALLEY SERVICES",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06457",
"telephone_number": "860-262-5358",
"fax_number": "860-262-5850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSSEAU-BICKNELL",
"first_name": "SANDRA",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.