Active NPI
Laura Perry Phillipe, LCSW
- Clinical Social Worker
- Manchester, CT
National Provider Identifier
1386762680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004079
- Practice address
- 71 Haynes St
Manchester, CT 06040-4131 - Phone
- (860) 647-6827
- Fax
- (860) 533-3452
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- 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 | 004079 | CT | Primary |
Addresses
Primary practice location
71 Haynes St
Manchester, CT 06040-4131
Mailing address
700 Misty Meadow LN
South Windsor, CT 06074-3652
Phone (860) 644-5094
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4079 | CT | MD | Professional Counselor |
| 004079 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558915200000",
"number": "1386762680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 MISTY MEADOW LN",
"city": "SOUTH WINDSOR",
"state": "CT",
"postal_code": "060743652",
"telephone_number": "860-644-5094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 HAYNES ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404131",
"telephone_number": "860-647-6827",
"fax_number": "860-533-3452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY PHILLIPE",
"first_name": "LAURA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2019-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "004079",
"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 May 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.