Individual provider Active NPI

Jillian Alexandria Tuschhoff, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1386162105
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10842 Issued in CT
Practice address
62 Grant Street
Grant Street Partnership
New Haven, CT 06519-3456
Phone
(203) 503-3350
Fax
(203) 503-3370
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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 10842 CT Primary

Addresses

Primary practice location

62 Grant Street
Grant Street Partnership
New Haven, CT 06519-3456

Mailing address

400 Columbus Avenue
Credentialing Specialist
New Haven, CT 06519-1233
Phone (203) 503-3376

Other practice location 1

75 N Mountain Rd
New Britain, CT 06053-3468
Phone (860) 224-6367

Other identifiers 1

IdentifierTypeStateIssuer
004235918MedicaidCT

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
I20191118001902 CT Practitioner - Clinical Social Worker 2860824505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince Nov 5, 2019 Accepting new patients
Therapeutic Solutions of Cheshire Past Accepting new patients

Locations

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

Interoperability endpoints

  • Direct secure messaging: jillian.tuschhoff.p1@direct.wheelerclinic.nextgenshare.com

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1386162105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3376",
            "fax_number": "203-503-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 GRANT STREET",
            "address_2": "GRANT STREET PARTNERSHIP",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065193456",
            "telephone_number": "203-503-3350",
            "fax_number": "203-503-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 N Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060533468",
            "country_code": "US",
            "telephone_number": "860-224-6367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUSCHHOFF",
        "first_name": "JILLIAN",
        "middle_name": "ALEXANDRIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.