Individual provider Active NPI

Christine O'Grady, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1285141077
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00985 Issued in CT
Practice address
28 Crescent St
Middletown, CT 06457-3654
Phone
(860) 358-4825
Fax
(860) 358-4457
NPI assigned
Jan 3, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 00985 CT Primary

Addresses

Primary practice location

28 Crescent St
Middletown, CT 06457-3654

Mailing address

40 West St
Middletown, CT 06457-3008
Phone (860) 840-8190

Other identifiers 1

IdentifierTypeStateIssuer
009985OtherCTCT DEPARTMENT OF PUBLIC HEALTH

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
I20180123001207 CT Practitioner - Clinical Social Worker 6002175999 Practice locations: Middletown, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00985CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1285141077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WEST ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573008",
            "telephone_number": "860-840-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4825",
            "fax_number": "860-358-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GRADY",
        "first_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "00985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "009985",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.