Active NPI
Mark Austin, LCSW
- Clinical Social Worker
- Manchester, CT
National Provider Identifier
1356840953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 009222
- Practice address
- 155 Cougar Dr
Manchester, CT 06040-6380 - Phone
- (860) 794-7497
- NPI assigned
- Feb 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 009222 | CT | Primary |
Addresses
Primary practice location
155 Cougar Dr
Manchester, CT 06040-6380
Mailing address
155 Cougar Dr
Manchester, CT 06040-6380
Phone (860) 794-7497
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009222 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518048000000",
"number": "1356840953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 COUGAR DR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060406380",
"telephone_number": "860-794-7497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 COUGAR DR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060406380",
"telephone_number": "860-794-7497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "MARK",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-08",
"last_updated": "2018-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "009222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.