Individual provider Active NPI

Harry Rosenberg, LCSW

  • Clinical Social Worker
  • Orange, CT
National Provider Identifier
1306967278
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001612 Issued in CT
Practice address
810 Robert Treat Dr
Orange, CT 06477-1617
Phone
(203) 988-1629
Fax
(203) 288-3655
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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 001612 CT Primary

Addresses

Primary practice location

810 Robert Treat Dr
Orange, CT 06477-1617

Mailing address

810 Robert Treat Dr
Orange, CT 06477-1617
Phone (203) 988-1629

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
I20051019000515 CT Practitioner - Clinical Social Worker 0042236036 Practice locations: Orange, CT; Stratford, CT; Hamden, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

295 Washington Ave
Hamden, CT 06518-3025
Phone (203) 988-1629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001612CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric and Adult Psychiatry, LLC Past Accepting new patients
Geriatric and Adult Psychiatry, LLC PastSince Nov 19, 1993 Accepting new patients
Oasis Physical Therapy PLLC PastSince Mar 28, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1306967278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ROBERT TREAT DR",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771617",
            "telephone_number": "203-988-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ROBERT TREAT DR",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771617",
            "telephone_number": "203-988-1629",
            "fax_number": "203-288-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "HARRY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

Verify at the official NPI Registry.