Individual provider Active NPI

Isoken Iyamu-Osagie, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1386089548
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009241 Issued in CT
Practice address
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone
(860) 545-7200
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 009241 CT Primary

Addresses

Primary practice location

200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309

Mailing address

200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone (860) 545-7200

Other identifiers 1

IdentifierTypeStateIssuer
1386089548MedicaidCT

Other names 1

  • Erica Isoken Iyamu-Osagie Professional 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
I20200717001581 CT Practitioner - Clinical Social Worker 6800210295 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009241CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince May 19, 2020 Accepting new patients
Hartford Hospital CurrentSince May 19, 2020 Accepting new patients

Locations

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

Interoperability endpoints

  • Direct secure messaging: erica.iyamu-osagie@xdr.hhchealthdirect.org

Organizations & group practices 2

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": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1386089548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVENUE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVENUE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYAMU-OSAGIE",
        "first_name": "ISOKEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386089548",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA ISOKEN",
            "last_name": "IYAMU-OSAGIE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.