Randi Nathan Hall, LCSW

Individual provider Active NPI Clinical Social Worker · Northfield, CT

NPI 1346487196 · NPPES record last updated Jan 15, 2009

Key facts

NPI
1346487196
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
005428 (CT)
Practice address
104 Campville Rd
Northfield, CT 06778-2622
Phone
(203) 206-3305
NPI assigned
Jan 15, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Resource Center (2 clinicians)

Practice addresses (Care Compare)

14 S Main St
Thomaston, CT 06787-1734
Phone (203) 578-5072

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150506001064 CT Practitioner - Clinical Social Worker 0840519294 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
001328CTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 005428 CT Yes

Addresses

Primary practice location

104 Campville Rd
Northfield, CT 06778-2622

Mailing address

104 Campville Rd
Northfield, CT 06778-2622
Phone (203) 206-3305

Other providers in Northfield, CT

All providers in Northfield, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.