Individual provider Active NPI

Laurel J Guertin, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1346388675
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
012681 Issued in CT
Practice address
230 Main Street Ext
Middletown, CT 06457-4470
Phone
(860) 343-5300
NPI assigned
Feb 1, 2007
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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 012681 CT Primary

Addresses

Primary practice location

230 Main Street Ext
Middletown, CT 06457-4470

Mailing address

222 Main Street Extension, PO Box 1000
Middletown, CT 06457-1000
Phone (860) 343-5300

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
I20230323002016 CT Practitioner - Clinical Social Worker 3173627452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gilead Community Services, Inc.Group PAC ID 0244289643, 9 clinicians

Practice addresses (Care Compare)

230 Main St Ext
Middletown, CT 06457-4470
Phone 86034353003421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012681CTMDClinical Social Worker
12681CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Counseling Centers Employee Support Systems, Inc. Clinical CurrentSince Mar 8, 2007 Accepting new patients
Gilead Community Services, Inc. CurrentSince Feb 27, 2023 Accepting new patients

Locations

222 Main Street Ext
Middletown, CT 06457
Phone (860) 343-5300

230 Main Street Ext
Middletown, CT 06457
Phone (860) 343-5300

804 W 9th St N
Ste B
Ladysmith, WI 54848
Phone (715) 532-9771

406 Technology Dr E
Ste B
Menomonie, WI 54751
Phone (715) 235-1839

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1346388675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN STREET EXTENSION, PO BOX 1000",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571000",
            "telephone_number": "860-343-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MAIN STREET EXT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574470",
            "telephone_number": "860-343-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERTIN",
        "first_name": "LAUREL",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.