Taylor Adah Humbert, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008944 Issued in CT

Practice address

86 Wilmont St
Wethersfield, CT 06109

Phone

(845) 642-4159

NPI assigned

Oct 8, 2010

Last updated

Oct 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Taylor Petekiewicz Former name

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians

Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

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

• Connecticut Mental Health Specialists Inc

  • Psychiatry Physician
  • Farmington, CT
  • NPI 1053362814

  Clinical

  Medicare reassignment Care Compare group NPD
• Value Based Long Term Care K PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1831921378
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1437469426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WILMONT ST",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091950",
            "telephone_number": "845-642-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 WILMONT ST",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "06109",
            "telephone_number": "845-642-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBERT",
        "first_name": "TAYLOR",
        "middle_name": "ADAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008944",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CT",
            "license": "C092015000642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "PETEKIEWICZ",
            "credential": "M.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Viveca Holman, DPT
• Honor Care Services Connecticut, Inc.
• Ly Hopkins, DMD
• Patrice Mary Horan, NP
• Yifan Huang, PHARM.D
• Hannah Hurtenbach
• John Charles Huston, MD
• Maryam Iftikhar
• Integrated Procare Services
• Intercommunity Mental Health Group

• Clinical Social Worker in Wethersfield, CT
• Providers in Wethersfield, 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 Oct 23, 2015; 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.