Individual provider Active NPI

Elizabeth Ann Mannarino, LCSW

  • Clinical Social Worker
  • Manchester, CT
National Provider Identifier
1629716733
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW.006091 Issued in CT
Practice address
317 N Main St
Manchester, CT 06042-2007
Phone
(860) 643-2101
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 MSW.006091 CT Primary

Addresses

Primary practice location

317 N Main St
Manchester, CT 06042-2007

Mailing address

1171 Grant Hill Rd
Coventry, CT 06238-1159
Phone (860) 709-3585

Other identifiers 1

IdentifierTypeStateIssuer
MSW.006091OtherCTAETNA

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
I20240126000097 CT Practitioner - Clinical Social Worker 4880047810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW.006091CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 19, 2023 Accepting new patients
Community Child Guidance Clinic, Inc. PastSince May 29, 2022 Accepting new patients

Locations

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1629716733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 GRANT HILL RD",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062381159",
            "telephone_number": "860-709-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422007",
            "telephone_number": "860-643-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARINO",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "MSW.006091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "MSW.006091",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.