Individual provider Active NPI

Richard Anthony Radocchia, LCSW

  • Clinical Social Worker
  • Shelton, CT
National Provider Identifier
1265713168
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002533 Issued in CT
Practice address
39 Coram Rd Apt 16
Shelton, CT 06484-4015
Phone
(203) 400-4941
NPI assigned
Sep 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 002533 CT Primary

Addresses

Primary practice location

39 Coram Rd Apt 16
Shelton, CT 06484-4015

Mailing address

39 Coram Rd Apt 16
Shelton, CT 06484-4015
Phone (203) 400-4941

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
I20130924000551 CT Practitioner - Clinical Social Worker 1254575764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1302 Chapel St
New Haven, CT 06511-4515
Phone (203) 624-0947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002533CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Apnh: a Place to Nourish Your Health Clinical CurrentSince Sep 21, 2014 Accepting new patients

Locations

1302 Chapel St
New Haven, CT 06511
Phone (203) 401-4453

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1265713168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CORAM RD APT 16",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844015",
            "telephone_number": "203-400-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CORAM RD APT 16",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844015",
            "telephone_number": "203-400-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOCCHIA",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.