Mesa Professional Co. LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MESA PROFESSIONAL CO. LLC

Practice address

483 Forest St
East Hartford, CT 06118-2000

Phone

(860) 578-8783

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Lisette Rodriguez, LCSW

Title

Owner/Manager

Phone

(860) 578-8783

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1487409116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 FOREST ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061182000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 FOREST ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061182000",
            "telephone_number": "860-578-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA PROFESSIONAL CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LISETTE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "860-578-8783",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in East Hartford, CT
• Providers in East Hartford, 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 Apr 17, 2024; 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.