Kimberly Patterson Mishriky, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

15 Mercer Ave
School Based Health Center
East Hartford, CT 06118-1517

Phone

(860) 622-5513

NPI assigned

Sep 15, 2008

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

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Intercommunity, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1073548533
  Medicare reassignment NPD
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1396994455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CANDLELIGHT DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332537",
            "telephone_number": "860-633-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MERCER AVE",
            "address_2": "SCHOOL BASED HEALTH CENTER",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181517",
            "telephone_number": "860-622-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRIKY",
        "first_name": "KIMBERLY",
        "middle_name": "PATTERSON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "006850",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Keith Miller, M.D.
• Timothy Z Millican, APRN, CRNA
• David Mintell, MD
• Michael Anthony Miranda Jr., M.D.
• Maliha Misbah
• Andrea Mitchell
• Maxwell Lawrence Stephen Mitchell, D.C.
• Nazahria Ayanna Mitchell
• Samantha Moberger, PA-C
• Benson Monastersky, D.M.D.

• Clinical Social Worker in East Hartford, CT
• Providers in East Hartford, 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 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.