Individual provider Active NPI

Peggy Arlene Lane, LCSW

  • Clinical Social Worker
  • Yalesville, CT
National Provider Identifier
1629185590
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002938 Issued in CT
Practice address
300 Church St
Yalesville, CT 06492
Phone
(203) 265-7770
Fax
(203) 237-2360
NPI assigned
Aug 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 002938 CT Primary

Addresses

Primary practice location

300 Church St
Yalesville, CT 06492

Mailing address

300 Church St
Yalesville, CT 06492
Phone (203) 265-7770

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
I20041123000702 CT Practitioner - Clinical Social Worker 3072578608 Reassigns benefits to 1 organization
Practice locations: Meriden, CT; Yalesville, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Church St
Yalesville, CT 06492-2253
Phone (203) 265-7770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002938CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Paths Counseling, LLC Clinical CurrentSince Jan 1, 2018 Accepting new patients
Silvia Sandoval, LCSW Clinical Past Accepting new patients

Locations

300 Church St
Yalesville, CT 06492
Phone (203) 265-7770

300 Church St
Ste 202
Yalesville, CT 06492
Phone (203) 265-7770

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629185590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-7770",
            "fax_number": "203-237-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-7770",
            "fax_number": "203-237-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "PEGGY",
        "middle_name": "ARLENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yalesville, CT

Sources for this page

Verify at the official NPI Registry.