Ashley Bruckenthal

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

30 Deepwood Dr
Bethel, CT 06801-1267

Phone

(203) 927-8907

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashley.bruckenthal@chcict.eclinicaldirectplus.com

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.

• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1952591851

  Clinical

  Medicare reassignment NPD
• Ashley Monck LCSW LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bethel, CT
  • NPI 1104402148
  NPD Authorized official
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1003332446
  NPD

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1295281178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 DANBURY RD STE 337",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DEEPWOOD DR",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011267",
            "telephone_number": "203-927-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKENTHAL",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "P03381",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336163963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Boulanger, R.PH
• Eileen Bow, PT
• Boylan Chiropractic LLC
• Donna Marie Boylan, D.C
• Alison Brown, LCSW
• Quoc Anh Bui, R.PH
• Judith A Burke, CD(DONA) PCD(DONA)
• C O R E ABA
• Calept, LLC
• Virginia Cameron, MSW

• Clinical Social Worker in Bethel, CT
• Providers in Bethel, 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 Sep 2, 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.