Individual provider Active NPI

Dianna Rodriguez, LCSW

  • Clinical Social Worker
  • New London, CT
National Provider Identifier
1528502457
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9593 Issued in CT
Practice address
One Shaw's Cove
New London, CT 06320-6302
Phone
(860) 447-8304
Fax
(860) 443-8720
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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 9593 CT Primary

Addresses

Primary practice location

One Shaw's Cove
New London, CT 06320-6302

Mailing address

One Shaw's Cove
New London, CT 06320-6302
Phone (860) 447-8304

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
I20240826002909 CT Practitioner - Clinical Social Worker 4981064979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Rutgers New Jersey Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

1 Shaws CV
New London, CT 06320-4902
Phone (860) 447-8304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9593CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc Clinical CurrentSince Jul 29, 2024 Accepting new patients
Community Health Center Inc CurrentSince Jul 29, 2024 Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

1 Shaws Cv
New London, CT 06320
Phone (860) 447-8304

Interoperability endpoints

  • Direct secure messaging: dianna.rodriguez@chcict.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1528502457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE SHAW'S COVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206302",
            "telephone_number": "860-447-8304",
            "fax_number": "860-443-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE SHAW'S COVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206302",
            "telephone_number": "860-447-8304",
            "fax_number": "860-443-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DIANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.