Active NPI
Melissa Agnelli Rondeau, LCSW
- Clinical Social Worker
- Norwich, CT
National Provider Identifier
1457973810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004232
- Practice address
- 77 Gifford St
Norwich, CT 06360-4041 - Phone
- (860) 608-6986
- NPI assigned
- May 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 004232 | CT | Primary |
Addresses
Primary practice location
77 Gifford St
Norwich, CT 06360-4041
Mailing address
77 Gifford St
Norwich, CT 06360-4041
Phone (860) 608-6986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004232 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wagner Medical PC | Clinical | Current | Accepting new patients |
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636
100 Church St
Fl 8
New York, NY 10007
Phone (646) 357-3609
Organizations & group practices 2
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": "1588896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1457973810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 GIFFORD ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604041",
"telephone_number": "860-608-6986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 GIFFORD ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604041",
"telephone_number": "860-608-6986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RONDEAU",
"first_name": "MELISSA",
"middle_name": "AGNELLI",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-08",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "004232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.