Active NPI
Robert F Adam, LCSW
- Clinical Social Worker
- Eastford, CT
National Provider Identifier
1467513291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004584
- Practice address
- 289 Chaplin Rd
Eastford, CT 06242-9442 - Phone
- (860) 974-0036
- NPI assigned
- Dec 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 004584 | CT | Primary |
Addresses
Primary practice location
289 Chaplin Rd
Eastford, CT 06242-9442
Mailing address
289 Chaplin Rd
Eastford, CT 06242-9442
Phone (860) 974-0036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140004584CT02 | Other | CT | PROVIDER ID BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004584 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Health Associates LLC | Clinical | 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, 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": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467513291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 CHAPLIN RD",
"city": "EASTFORD",
"state": "CT",
"postal_code": "062429442",
"telephone_number": "860-974-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 CHAPLIN RD",
"city": "EASTFORD",
"state": "CT",
"postal_code": "062429442",
"telephone_number": "860-974-0036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAM",
"first_name": "ROBERT",
"middle_name": "F",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "004584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER ID BLUE CROSS",
"identifier": "140004584CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eastford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.