Active NPI
Matthew Alan Ahlberg
- Social Worker
- West Hartford, CT
National Provider Identifier
1609533595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 5864
- Practice address
- 17 S Highland St
West Hartford, CT 06119-1826 - Phone
- (860) 258-4171
- NPI assigned
- Nov 26, 2021
- Last updated
- Aug 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 5864 | CT | Primary |
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
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5864 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medop Behavioral Health Associates PC | Past | Accepting new patients | |
| High Watch Recovery Center | Past | 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.
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- Kent, CT
- NPI 1275946881
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- NPI 1053360677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.