Active NPI
Elizabeth Kellert
- Social Worker
- Willimantic, CT
National Provider Identifier
1609340272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 003634
- Practice address
- 1491 Main St
Willimantic, CT 06226-1914 - Phone
- (860) 456-3215
- Fax
- (860) 423-3351
- NPI assigned
- Jan 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 003634 | CT | Primary |
Addresses
Primary practice location
1491 Main St
Willimantic, CT 06226-1914
Mailing address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 697-3351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- University of Connecticut School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health and Wellness Center of Greater Torrington Inc
Practice addresses (Care Compare)
469 Migeon Ave
Torrington, CT 06790-4643
Phone (860) 489-0931
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychologist
- Boston, MA
- NPI 1740860428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547683200000",
"number": "1609340272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 DAY HILL RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951722",
"telephone_number": "860-697-3351",
"fax_number": "860-731-5522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1491 MAIN ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261914",
"telephone_number": "860-456-3215",
"fax_number": "860-423-3351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLERT",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-17",
"last_updated": "2019-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "003634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.