Charisse Weston-Keldo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005890 Issued in CT

Practice address

93 Village Green Dr
New Britain, CT 06053-2652

Phone

(860) 777-6049

NPI assigned

Sep 21, 2017

Last updated

Jul 21, 2022By 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

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.

• A New Way Therapeutics

  • Clinical Social Worker
  • West Hartford, CT
  • NPI 1740786201
  NPD Authorized official
• State of Connecticut

  dba River Valley Services

  • Adult Mental Health Clinic/Center
  • Middletown, CT
  • NPI 1427074426
  Medicare reassignment

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235648205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 VILLAGE GREEN DR",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060532652",
            "telephone_number": "860-777-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 VILLAGE GREEN DR",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060532652",
            "telephone_number": "860-777-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON-KELDO",
        "first_name": "CHARISSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "005890",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Trevon Damon Whelton-Gibson
• Douglas Whipple I, M.D.

• Clinical Social Worker in New Britain, CT
• Providers in New Britain, 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 Jul 21, 2022; 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.