Individual provider Active NPI

Catherine Lan Nguyen, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1598074239
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008805 Issued in CT
Practice address
1669 Thomaston Ave
Waterbury, CT 06704-1026
Phone
(203) 759-3505
Fax
(203) 759-3529
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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 008805 CT Primary

Addresses

Primary practice location

1669 Thomaston Ave
Waterbury, CT 06704-1026

Mailing address

1669 Thomaston Ave
Waterbury, CT 06704-1026
Phone (203) 759-3505

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
I20150622000036 CT Practitioner - Clinical Social Worker 6507177318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

55 W Main St
Waterbury, CT 06702-5524
Phone (203) 805-6414

55 W Main St
Suite 410
Waterbury, CT 06702-5501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008805CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Apr 3, 2015 Accepting new patients
State of Connecticut CurrentSince Apr 3, 2015 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

1669 Thomaston Ave
Waterbury, CT 06704
Phone (203) 759-3599

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": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1598074239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 THOMASTON AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041026",
            "telephone_number": "203-759-3505",
            "fax_number": "203-759-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 THOMASTON AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041026",
            "telephone_number": "203-759-3505",
            "fax_number": "203-759-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CATHERINE",
        "middle_name": "LAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.