Matthew Alan Ahlberg – Social Worker

Key facts

NPI: 1609533595
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
License: 5864 (CT)
Practice address: 17 S Highland St
West Hartford, CT 06119-1826
Phone: (860) 258-4171
NPI assigned: Nov 26, 2021
Sex: Male
Sole proprietor: Yes

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.

High Watch Recovery Center Substance Abuse Rehabilitation Facility · Kent, CT · NPI 1275946881

NPD (past)
Medop Behavioral Health Associates PC Neurology Physician · Old Lyme, CT · NPI 1053360677

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
5864	CT	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
High Watch Recovery Center		Past since Nov 1, 2021	Accepting new patients
Medop Behavioral Health Associates PC		Past since Nov 1, 2021	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X	5864	CT	Yes

Addresses

Primary practice location

17 S Highland St
West Hartford, CT 06119-1826

Mailing address

62 Carter Rd
Kent, CT 06757
Phone (860) 927-3772

Other practice location 1

62 Carter Rd
Kent, CT 06757
Phone (860) 927-3772 ext. 130

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 4, 2023.

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1609533595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CARTER RD",
            "city": "KENT",
            "state": "CT",
            "postal_code": "06757",
            "telephone_number": "860-927-3772",
            "fax_number": "860-927-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Carter Rd",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "CT",
            "postal_code": "06757",
            "country_code": "US",
            "telephone_number": "860-927-3772 x130",
            "fax_number": "860-927-3515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHLBERG",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-26",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "5864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

All providers in West Hartford, CT · Social Worker in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.