Portia Pendleton, LCSW LLC.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PORTIA PENDLETON, LCSW LLC.

Practice address

251 Main St Ste 200
Old Saybrook, CT 06475-2357

Phone

(860) 245-9598

NPI assigned

Mar 23, 2020

Last updated

Mar 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Portia Pendleton, LCSWNPI 1104374230

Title

Owner

Phone

(860) 759-9162

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Portia Pendleton, LMSW

  • Clinical Social Worker
  • Essex, CT
  • NPI 1104374230
  NPD Authorized official

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1285261156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ROGERS LAKE TRL",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711223",
            "telephone_number": "860-759-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MAIN ST STE 200",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752357",
            "telephone_number": "860-245-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTIA PENDLETON, LCSW LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "PORTIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-759-9162",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Noel Quinn

• Clinical Social Worker in Old Saybrook, CT
• Providers in Old Saybrook, 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 Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.