Bonnie A Redderoth, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002265 Issued in CT

Practice address

61 S Main St Ste 307
West Hartford, CT 06107-2403

Phone

(860) 523-0288

NPI assigned

Feb 14, 2007

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1356484125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 S MAIN ST STE 307",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072403",
            "telephone_number": "860-523-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 S MAIN ST STE 307",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072403",
            "telephone_number": "860-523-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDEROTH",
        "first_name": "BONNIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002265CT",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "140002265CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ray of Sunshine Optical,LLC (The Eyeglass Place of West Hartford)
• Raymond L Almeida LCSW LLC
• Real Life Medical LLC
• Rebecca a Filkoff (Nationwide Wig Imports)
• Jason Seth Recchia, PTA
• Kathryn Redman, DPT
• Chanda Tamara Reece
• Reflections LLC
• Reflections LLC (West Hartford Holistic Counseling Center)
• Heather Nicole Regan, DPT

• Clinical Social Worker in West Hartford, CT
• Providers in West Hartford, 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 Oct 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.