Individual provider Active NPI

Michel Georges Duques, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1417028234
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001226 Issued in CT
Practice address
147 Bishop St
New Haven, CT 06511-3717
Phone
(203) 624-4457
NPI assigned
Nov 13, 2006
Sex
Male
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 001226 CT Primary

Addresses

Primary practice location

147 Bishop St
New Haven, CT 06511-3717

Mailing address

147 Bishop St
New Haven, CT 06511-3717
Phone (203) 624-4457

Other identifiers 1

IdentifierTypeStateIssuer
004184511MedicaidCT

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
I20111130000754 CT Practitioner - Clinical Social Worker 0143494161 Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

147 Bishop St
New Haven, CT 06511-3717
Phone (203) 624-4457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001226CTMDMarriage & Family Therapist
1226CTMDTaxi

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia M Shiller, PH.D., LLC Past Accepting new patients

Organizations & group practices 1

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417028234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 BISHOP ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113717",
            "telephone_number": "203-624-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 BISHOP ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113717",
            "telephone_number": "203-624-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUES",
        "first_name": "MICHEL",
        "middle_name": "GEORGES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004184511",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.