Individual provider Active NPI

Judy K Hennessy, LCSW

  • Clinical Social Worker
  • West Haven, CT
National Provider Identifier
1356733778
Registry record updated Feb 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008408 Issued in CT
Practice address
415 Main St
West Haven, CT 06516-4296
Phone
(203) 931-1184
NPI assigned
Feb 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2015

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 008408 CT Primary

Addresses

Primary practice location

415 Main St
West Haven, CT 06516-4296

Mailing address

761 W Woods Rd
Hamden, CT 06518-1837
Phone (203) 668-9648

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
I20150605001554 CT Practitioner - Clinical Social Worker 9739400482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

79 Blue TRL
Hamden, CT 06518-1619
Phone (203) 675-1760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Apr 28, 2015 Accepting new patients
State of Connecticut CurrentSince Apr 28, 2015 Accepting new patients
Integrative Health and Healing LLC CurrentSince Mar 31, 2020 Accepting new patients

Locations

555 Highland Ave
Cheshire, CT 06410
Phone (203) 263-9449

165 Capitol Ave
Ste 2000
Hartford, CT 06106

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424563200000",
    "number": "1356733778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 W WOODS RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181837",
            "telephone_number": "203-668-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-931-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "JUDY",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-22",
        "last_updated": "2015-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.