Individual provider Active NPI

Martin Sinclair Perry, LMSW

  • Social Worker
  • Waterbury, CT
National Provider Identifier
1437390655
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3214 Issued in CT
Practice address
141 E Main St FL 1
Waterbury, CT 06702-2310
Phone
(203) 574-9000
Fax
(203) 574-9006
NPI assigned
Mar 18, 2009
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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 3214 CT Primary

Addresses

Primary practice location

141 E Main St FL 1
Waterbury, CT 06702-2310

Mailing address

3013 Dixwell Ave
Hamden, CT 06518-3527
Phone (203) 399-6071

Other practice location 1

501 Lombard St
New Haven, CT 06513-2910
Phone (203) 787-2207 ext. 230

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
I20201130003065 CT Practitioner - Clinical Social Worker 1456762251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Health and Wellness Solutions of CT LLCGroup PAC ID 5395020945, 8 clinicians

Practice addresses (Care Compare)

3013 Dixwell Ave
Hamden, CT 06518-3527
Phone 20339960710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health and Wellness Solutions of CT, LLC CurrentSince Aug 14, 2020 Accepting new patients

Locations

3013 Dixwell Ave
Hamden, CT 06518
Phone (203) 399-6071

3013 Dixwell Ave
Ste 1
Hamden, CT 06518
Phone (203) 400-1884

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1437390655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3013 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183527",
            "telephone_number": "203-399-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST FL 1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Lombard St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065132910",
            "country_code": "US",
            "telephone_number": "203-787-2207 x230",
            "fax_number": "203-773-3626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MARTIN",
        "middle_name": "SINCLAIR",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-18",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "3214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.