Individual provider Active NPI

Mary Ellen Ladd, LCSW

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1346267135
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004701 Issued in CT
Practice address
784 Farmington Ave
West Hartford, CT 06119-1619
Phone
(860) 523-4450
Fax
(860) 523-9537
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 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 004701 CT Primary

Addresses

Primary practice location

784 Farmington Ave
West Hartford, CT 06119-1619

Mailing address

784 Farmington Ave
West Hartford, CT 06119-1619
Phone (860) 523-4450

Other identifiers 1

IdentifierTypeStateIssuer
004231320MedicaidCT

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
I20090601000007 CT Practitioner - Clinical Social Worker 3072662683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Women'S Center for Psychotherapy LLCGroup PAC ID 1658305636, 4 clinicians

Practice addresses (Care Compare)

784 Farmington Ave
West Hartford, CT 06119-1619
Phone (860) 523-4450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004701CTMDPhysical Therapist
4701CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Center for Psychotherapy,LLC Clinical CurrentSince May 29, 2009 Accepting new patients
Clementine Counseling PastSince May 7, 2023 Accepting new patients

Locations

784 Farmington Ave
West Hartford, CT 06119
Phone (860) 245-9077

Organizations & group practices 2

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1346267135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-523-4450",
            "fax_number": "860-523-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-523-4450",
            "fax_number": "860-523-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "MARY ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004231320",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.