Individual provider Active NPI

Andrea Cook Basel, LCSW

  • Clinical Social Worker
  • Guilford, CT
National Provider Identifier
1598202061
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009545 Issued in CT
Practice address
303 Church St Unit B
Guilford, CT 06437-2468
Phone
(203) 815-5288
NPI assigned
Jan 23, 2017
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 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 009545 CT Primary

Addresses

Primary practice location

303 Church St Unit B
Guilford, CT 06437-2468

Mailing address

119 Highwoods Dr
Guilford, CT 06437-1942
Phone (203) 815-5288

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
I20180223000538 CT Practitioner - Clinical Social Worker 5193086742 Reassigns benefits to 1 organization
Practice locations: Guilford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

303 Church St
Unit B
Guilford, CT 06437-2468
Phone (203) 815-5288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009545CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia L Sarris, PA, LLC Clinical CurrentSince Jan 15, 2018 Accepting new patients
Cynthia L. Sarris, LCSW, PA Clinical PastSince Jan 15, 2018 Accepting new patients

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, 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": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1598202061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HIGHWOODS DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371942",
            "telephone_number": "203-815-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CHURCH ST UNIT B",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372468",
            "telephone_number": "203-815-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASEL",
        "first_name": "ANDREA",
        "middle_name": "COOK",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.