Individual provider Active NPI

Pamala Standfest, LCSW

  • Clinical Social Worker
  • Putnam, CT
National Provider Identifier
1528036258
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004199 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
Fax
(860) 963-7917
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 004199 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

336 Cooper LN
Coventry, CT 06238-1604
Phone (860) 622-5340

Other practice location 1

869 Forbes St
East Hartford, CT 06118-1958
Phone (860) 622-5340

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170815001635 CT Practitioner - Clinical Social Worker 2668744434

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Generations Family Health Center IncGroup PAC ID 4880640630, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004199CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Services, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528036258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 COOPER LN",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062381604",
            "telephone_number": "860-622-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917",
            "fax_number": "860-963-7917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "869 Forbes St",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061181958",
            "country_code": "US",
            "telephone_number": "860-622-5340",
            "fax_number": "860-622-5342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANDFEST",
        "first_name": "PAMALA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.