Individual provider Active NPI

Colleen Lahart Porth, LCSW

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1629340450
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007598 Issued in CT
Practice address
90 N Main St
West Hartford, CT 06107-1924
Phone
(860) 561-1175
Fax
(860) 561-3382
NPI assigned
Feb 9, 2012
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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 007598 CT Primary

Addresses

Primary practice location

90 N Main St
West Hartford, CT 06107-1924

Mailing address

90 N Main St
West Hartford, CT 06107-1924
Phone (860) 561-1175

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
I20130930000142 CT Practitioner - Clinical Social Worker 6103050455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Counseling CenterGroup PAC ID 7618239393, 17 clinicians

Practice addresses (Care Compare)

966 S Main St
Plantsville, CT 06479-1645
Phone (860) 384-7056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007598CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services of Greater Hartford Clinical CurrentSince Aug 19, 2013 Accepting new patients
Hopeworks, Inc Past Accepting new patients

Locations

333 Bloomfield Ave
Ste A
West Hartford, CT 06117
Phone (860) 236-1927

Organizations & group practices 3

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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1629340450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071924",
            "telephone_number": "860-561-1175",
            "fax_number": "860-561-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071924",
            "telephone_number": "860-561-1175",
            "fax_number": "860-561-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTH",
        "first_name": "COLLEEN",
        "middle_name": "LAHART",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.