Amy Roe

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10195 Issued in CT

Practice address

21 Montauk Ave
New London, CT 06320-4906

Phone

(860) 439-6400

Fax

(860) 390-1463

NPI assigned

Sep 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Faenza Former name

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

Practice roles

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.

• United Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayville, CT
  • NPI 1063413011
  Medicare reassignment NPD
• Sound Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1396700886
  Medicare reassignment
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1275934226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063200390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-439-6400",
            "fax_number": "860-390-1463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 N Main St",
            "address_purpose": "LOCATION",
            "city": "Dayville",
            "state": "CT",
            "postal_code": "062412170",
            "country_code": "US",
            "telephone_number": "607-742-0208",
            "fax_number": "860-774-0826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROE",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FAENZA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lasharae G Rock, BSW
• Dianna Rodriguez, LCSW
• Elizabeth T Rodriguez, LMSW
• Katherine Rodriguez
• Margarita Enid Rodriguez, BA
• Mark Edward Rogers, PHARM.D.
• Hannah Rojas
• Daniel Rolotti, DMD
• Miguel Angel Roman
• Kiersten Rooney

• Clinical Social Worker in New London, CT
• Providers in New London, 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 Jan 14, 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.