Individual provider Active NPI

Carlotta Berg Hanson, LCSW

  • Clinical Social Worker
  • Danbury, CT
National Provider Identifier
1407907876
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004308 Issued in CT
Practice address
36 Mill Plain Rd
Danbury, CT 06811-5181
Phone
(293) 797-8222
Fax
(203) 744-5550
NPI assigned
Jan 14, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 004308 CT Primary

Addresses

Primary practice location

36 Mill Plain Rd
Danbury, CT 06811-5181

Mailing address

36 Mill Plain Rd
Danbury, CT 06811-5181
Phone (293) 797-8222

Other identifiers 2

IdentifierTypeStateIssuer
166264OtherCTPROVIDER ID
235767OtherCTPROVIDER ID

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
I20050112000637 CT Practitioner - Clinical Social Worker 4183672579 Practice locations: Danbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

36 Mill Plain Rd
Suite 401
Danbury, CT 06811-5114
Phone (203) 797-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004308CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407907876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MILL PLAIN RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115181",
            "telephone_number": "293-797-8222",
            "fax_number": "203-744-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MILL PLAIN RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115181",
            "telephone_number": "293-797-8222",
            "fax_number": "203-744-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG HANSON",
        "first_name": "CARLOTTA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "166264",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "235767",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.