Individual provider Active NPI

Amy Rodriguez, L.C.S.W.

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1245664770
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8397 Issued in CT
Practice address
2550 Main Street
Hartford, CT 06120
Phone
(860) 548-0101
Fax
(860) 524-7781
NPI assigned
Sep 3, 2013
Last updated
Sep 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8397 CT Primary

Addresses

Primary practice location

2550 Main Street
Hartford, CT 06120

Mailing address

2550 Main Street
Hartford, CT 06120
Phone (860) 548-0101

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
I20131107000153 CT Practitioner - Clinical Social Worker 9537394192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8397CTMDClinical Social Worker
008397CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Clinical CurrentSince Sep 1, 2016 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

6 Fieldstone Cmns
Ste D
Tolland, CT 06084
Phone (860) 871-6710

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1245664770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MAIN STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06120",
            "telephone_number": "860-548-0101",
            "fax_number": "860-524-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MAIN STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06120",
            "telephone_number": "860-548-0101",
            "fax_number": "860-524-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.