Active NPI
Elisabeth Oldmixon, LSW
- Social Worker
- Newington, CT
National Provider Identifier
1568214955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05399600
- Practice address
- 171 Market SQ Ste 206B
Newington, CT 06111-2930 - Phone
- (617) 816-9011
- NPI assigned
- Apr 1, 2024
- Last updated
- May 7, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Social Worker | 104100000X | 44SL05399600 | NJ | Primary |
Addresses
Primary practice location
171 Market SQ Ste 206B
Newington, CT 06111-2930
Mailing address
3409 Lassiter Falls Cir
Raleigh, NC 27609-6973
Phone (201) 725-0639
Other practice location 1
3409 Lassiter Falls Cir
Raleigh, NC 27609-6973
Phone (201) 725-0639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05399600 | NJ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liliana's Practice, LLC | Current | Accepting new patients | |
| Pathways of Idaho, LLC | Past | Accepting new patients | |
| The Counseling Collective, PLLC | Past | Accepting new patients |
Locations
171 Market Sq
Ste 206B
Newington, CT 06111
Phone (617) 816-9011
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.
-
- Clinical Social Worker
- Newington, CT
- NPI 1467212753
-
- Mental Health Counselor
- Wake Forest, NC
- NPI 1851863609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1568214955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 LASSITER FALLS CIR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096973",
"telephone_number": "201-725-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 MARKET SQ STE 206B",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061112930",
"telephone_number": "617-816-9011"
}
],
"practiceLocations": [
{
"address_1": "3409 Lassiter Falls Cir",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276096973",
"country_code": "US",
"telephone_number": "201-725-0639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLDMIXON",
"first_name": "ELISABETH",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-01",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05399600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.