Individual provider Active NPI

Constance L Mindell, DSW

  • Clinical Social Worker
  • Woodbridge, CT
National Provider Identifier
1467599753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001716 Issued in CT
Practice address
270 Amity Rd
Suite 220
Woodbridge, CT 06525-2236
Phone
(860) 216-5863
Fax
(860) 216-5864
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 001716 CT Primary

Addresses

Primary practice location

270 Amity Rd
Suite 220
Woodbridge, CT 06525-2236

Mailing address

270 Amity Rd
Suite 220
Woodbridge, CT 06525-2236
Phone (860) 216-5863

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

LicenseStateTypeSpecialty
001716CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467599753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 AMITY RD",
            "address_2": "SUITE 220",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252236",
            "telephone_number": "860-216-5863",
            "fax_number": "869-216-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 AMITY RD",
            "address_2": "SUITE 220",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252236",
            "telephone_number": "860-216-5863",
            "fax_number": "860-216-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDELL",
        "first_name": "CONSTANCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, 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.

Verify at the official NPI Registry.