Individual provider Active NPI

Taylor Chilly, LCSW

  • Clinical Social Worker
  • Ellington, CT
National Provider Identifier
1255976965
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13644 Issued in CT
Practice address
100 West Rd # 3
Ellington, CT 06029-3798
Phone
(860) 454-0520
NPI assigned
Nov 18, 2019
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X 13644 CT Primary

Addresses

Primary practice location

100 West Rd # 3
Ellington, CT 06029-3798

Mailing address

100 West Rd # 3
Ellington, CT 06029-3798
Phone (860) 454-0520

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
I20250923001725 CT Practitioner - Mental Health Counselor 5395240378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Windham Community Memorial Hospital IncGroup PAC ID 2961309059, 67 clinicians

Practice addresses (Care Compare)

112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-9116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13644CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Windham Community Memorial Hospital, Inc. CurrentSince Jul 18, 2025 Accepting new patients
The William W Backus Hospital CurrentSince Jul 18, 2025 Accepting new patients
Integrative Clinical Associates Clinical Current Accepting new patients
West Meadow Counseling, P.C. CurrentSince Jan 14, 2024 Accepting new patients
William W Backus Hospital CurrentSince Jul 18, 2025 Accepting new patients

Locations

100 West Rd
#3
Ellington, CT 06029
Phone (860) 454-0520

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Organizations & group practices 5

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1255976965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WEST RD # 3",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293798",
            "telephone_number": "860-454-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST RD # 3",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293798",
            "telephone_number": "860-454-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILLY",
        "first_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

Verify at the official NPI Registry.