Individual provider Active NPI

Rachelle Minkoff, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1396857967
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006067 Issued in CT
Practice address
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06109-3309
Phone
(860) 545-7229
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 006067 CT Primary

Addresses

Primary practice location

200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06109-3309

Mailing address

333 Bloomfield Ave
Suite a
West Hartford, CT 06117-1544
Phone (860) 236-1927

Other identifiers 1

IdentifierTypeStateIssuer
004083672MedicaidCT

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
I20060301000442 CT Practitioner - Clinical Social Worker 0840206785 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Health Associates LLCGroup PAC ID 9638066822, 11 clinicians

Practice addresses (Care Compare)

701 Cottage Grove Rd
Suite C210
Bloomfield, CT 06002-4207
Phone (860) 233-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006067CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Center for Psychotherapy,LLC Clinical CurrentSince Dec 10, 2019 Accepting new patients
Psychological Health Associates LLC Clinical CurrentSince May 1, 2021 Accepting new patients
Clementine Counseling CurrentSince May 7, 2023 Accepting new patients
Hartford Hospital CurrentSince May 23, 2017 Accepting new patients

Locations

701 Cottage Grove Rd
Ste C210
Bloomfield, CT 06002
Phone (860) 233-9772

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

784 Farmington Ave
West Hartford, CT 06119
Phone (860) 245-9077

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396857967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BLOOMFIELD AVE",
            "address_2": "SUITE A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171544",
            "telephone_number": "860-236-1927",
            "fax_number": "860-236-6483"
        },
        {
            "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": "061093309",
            "telephone_number": "860-545-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKOFF",
        "first_name": "RACHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004083672",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.