Individual provider Active NPI

Glenda Murdaugh, LCSWR

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1538704663
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13017 Issued in CT
Practice address
360 State St Apt 2808
New Haven, CT 06510-3628
Phone
(917) 270-0338
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 13017 CT Primary

Addresses

Primary practice location

360 State St Apt 2808
New Haven, CT 06510-3628

Mailing address

25 Broadway FL 8
New York, NY 10004-1073
Phone (917) 270-0338

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
I20240821000745 CT Practitioner - Clinical Social Worker 0648718643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Practice addresses (Care Compare)

111 Westcott Rd
Danielson, CT 06239-2929
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Care PC LLC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients

Locations

111 Westcott Rd
Danielson, CT 06239
Phone (860) 774-9540

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1538704663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BROADWAY FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041073",
            "telephone_number": "917-270-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 STATE ST APT 2808",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103628",
            "telephone_number": "917-270-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDAUGH",
        "first_name": "GLENDA",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.