Individual provider Active NPI

Connie Luise Dengler-Brockway, LSW

  • Social Worker
  • Mason, OH
National Provider Identifier
1417454026
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1500595 Issued in OH
Practice address
9895 Coventry CT
Mason, OH 45040-9543
Phone
(513) 515-4025
NPI assigned
Apr 10, 2018
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1500595 OH Primary

Addresses

Primary practice location

9895 Coventry CT
Mason, OH 45040-9543

Mailing address

9895 Coventry CT
Mason, OH 45040-9543
Phone (513) 515-4025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1500595OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1417454026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9895 COVENTRY CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409543",
            "telephone_number": "513-515-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9895 COVENTRY CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409543",
            "telephone_number": "513-515-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENGLER-BROCKWAY",
        "first_name": "CONNIE",
        "middle_name": "LUISE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1500595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.