Individual provider Active NPI

Erin Gardner-Flores, LCSW

  • Clinical Social Worker
  • Dayville, CT
National Provider Identifier
1346416435
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007485 Issued in CT
Practice address
1007 N Main Street
Dayville, CT 06241-0839
Phone
(860) 774-2020
Fax
(860) 779-5437
NPI assigned
May 7, 2008
Last updated
Feb 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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 007485 CT Primary

Addresses

Primary practice location

1007 N Main Street
Dayville, CT 06241-0839

Mailing address

395 Pequot Ave
Apt.. 5
New London, CT 06320-4440

Other identifiers 1

IdentifierTypeStateIssuer
004040564MedicaidCT

Other names 1

  • Erin Gardner Former name

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
I20110609000620 CT Practitioner - Clinical Social Worker 6103003694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

428 Long Hill Rd
Groton, CT 06340-3811
Phone (860) 333-9088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007485CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Gardner-Flores, LCSW, LLC Clinical CurrentSince May 9, 2018 Accepting new patients
United Services Inc CurrentSince Jan 4, 2017 Accepting new patients
Sarah Faucher LPC, LLC PastSince May 9, 2018 Accepting new patients

Locations

428 Long Hill Rd
Groton, CT 06340
Phone (860) 326-5454

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, 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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1346416435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 PEQUOT AVE",
            "address_2": "APT.. 5",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N MAIN STREET",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062410839",
            "telephone_number": "860-774-2020",
            "fax_number": "860-779-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER-FLORES",
        "first_name": "ERIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004040564",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "GARDNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayville, CT

Sources for this page

Verify at the official NPI Registry.