Charles F. Kirby III, LMSW-CC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

30 Hazel Ter Ste 11
Woodbridge, CT 06525-2240

Phone

(203) 819-7650

Fax

(203) 298-9487

NPI assigned

Sep 4, 2008

Last updated

Jul 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TR Counseling & Wellness LLC

  • Mental Health Counselor
  • Woodbridge, CT
  • NPI 1629494232
  Medicare reassignment NPD
• Anchored Soul Counseling, PLLC

  • Clinical Social Worker
  • North Haven, CT
  • NPI 1619515962
  NPD (past)
• State of Connecticut

  dba Department of Veterans' Affairs, Veterans Home

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD (past)

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1306094297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAZEL TER STE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252240",
            "telephone_number": "203-819-7650",
            "fax_number": "203-597-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAZEL TER STE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252240",
            "telephone_number": "203-819-7650",
            "fax_number": "203-298-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "CHARLES",
        "middle_name": "F.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LMSW-CC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-04",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC11253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaydian Harrison LCSW LLC
• Arlene Kaye, BCBA
• James A Killian, LPC
• Mijung Kim, APRN
• Su Jung Kim
• Hedy Kober, PHD
• Shamlee A Kulkarni, RD
• Lacc LLC
• Bianca Lastra
• Robert L Lavallee Jr., M.D.

• Clinical Social Worker in Woodbridge, CT
• Providers in Woodbridge, 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 Jul 21, 2024; 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.