Laurence Charles Segall, MS LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00193805 Issued in CT

Practice address

43 Old Hollow Road
Ste 43
Trumbull, CT 06611

Phone

(203) 722-7763

Fax

(203) 459-1226

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Shoreline Psychiatry of Western Connecticut, LLC

  • Psychiatry Physician
  • Norwalk, CT
  • NPI 1134251564
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326155607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 OLD HOLLOW ROAD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-722-7763",
            "fax_number": "203-459-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 OLD HOLLOW ROAD",
            "address_2": "STE 43",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-722-7763",
            "fax_number": "203-459-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALL",
        "first_name": "LAURENCE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MS LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "00193805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004242997",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Schramm
• Jennifer Kathryn Schreck, MD
• Edward Mark Schwartz
• Stefanie Seanor, OTR/L
• Daniel Searless
• Sekerak M.D. & Tristine M.D., PC
• Jared G Selter, MD
• Garline Senatus
• Senior Care Management LLC
• Charles Severo, P.A.

• Clinical Social Worker in Trumbull, CT
• Providers in Trumbull, 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 8, 2007; 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.