Individual provider Active NPI

Nancy Albert

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1235795360
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11613 Issued in CT
Practice address
322 Main St # 2E1J
Willimantic, CT 06226-3172
Phone
(860) 861-5794
NPI assigned
May 14, 2019
Last updated
Dec 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4563 CT
Clinical Social Worker 1041C0700X 011613 CT
Clinical Social Worker 1041C0700X 11613 CT Primary

Addresses

Primary practice location

322 Main St # 2E1J
Willimantic, CT 06226-3172

Mailing address

322 Main St # 2E1J
Willimantic, CT 06226-3172
Phone (860) 861-5794

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210902000452 CT Practitioner - Clinical Social Worker 4082010889 Practice locations: Willimantic, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011613CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Daring Voyage, LLC PastSince Sep 29, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1235795360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MAIN ST # 2E1J",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263172",
            "telephone_number": "860-861-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST # 2E1J",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263172",
            "telephone_number": "860-861-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERT",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "4563",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011613",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.