Michelle Keeslerconnor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007717 Issued in CT

Practice address

649 Amity Rd Unit 102
Bethany, CT 06524-3091

Phone

(203) 560-6430

NPI assigned

Feb 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  NPD (past)

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1396017117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "address_2": "SOCIAL WORK DEPARTMENT, EAST PAVILION 10-635",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065048900",
            "telephone_number": "203-688-1855",
            "fax_number": "203-688-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 AMITY RD UNIT 102",
            "city": "BETHANY",
            "state": "CT",
            "postal_code": "065243091",
            "telephone_number": "203-560-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESLERCONNOR",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasharon Hernandez, APRN PMHNP
• Infinite Well LLC
• Boaz Itshaky, MSOM
• Joni-Kay Tiffany Johnson, FNP
• Megan Johnson
• Concetta M Lafemina, LPC
• Linda Maude, PT, LLC
• Jake Mansfield
• Tina A McHugh, MS, LPC
• Cari Lauren Medwin, MSW

• Clinical Social Worker in Bethany, CT
• Providers in Bethany, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.