Individual provider Active NPI

Kaitlin Magalnick, LCSW

  • Clinical Social Worker
  • Avon, CT
National Provider Identifier
1548918709
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12076 Issued in CT
Practice address
21 Waterville Rd
Avon, CT 06001-2097
Phone
(860) 284-0182
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 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 12076 CT Primary

Addresses

Primary practice location

21 Waterville Rd
Avon, CT 06001-2097

Mailing address

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

Other identifiers 1

IdentifierTypeStateIssuer
12076OtherCTLCSW

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL harvestcare.com Other

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
I20220405002753 CT Practitioner - Clinical Social Worker 1153717830 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Apr 4, 2023 Accepting new patients
Harvest Healthcare LLC Clinical CurrentSince Mar 14, 2022 Accepting new patients
State of Connecticut CurrentSince Apr 4, 2023 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Organizations & group practices 3

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": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1548918709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-284-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-284-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGALNICK",
        "first_name": "KAITLIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "12076",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "harvestcare.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "21 Waterville Rd",
            "city": "Avon",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060012097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.