Individual provider Active NPI

Anneliis Koiv, LCSW

  • Clinical Social Worker
  • Windsor, CT
National Provider Identifier
1649340175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004752 Issued in CT
Practice address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone
(860) 731-5522
Fax
(860) 731-5534
NPI assigned
Nov 9, 2006
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 004752 CT Primary

Addresses

Primary practice location

995 Day Hill Rd
Windsor, CT 06095-1722

Mailing address

PO Box 1029
Avon, CT 06001-1029
Phone (860) 651-8193

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
I20050427001056 CT Practitioner - Clinical Social Worker 2668411893 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Farmington, CT 06032-1953
Phone (860) 677-5570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004752CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Mental Health Specialists Inc Clinical CurrentSince Mar 1, 2020 Accepting new patients
Hartford Hospital CurrentSince Jun 13, 2016 Accepting new patients
Hartford Hospital CurrentSince Jun 13, 2016 Accepting new patients
Hartford Hospital CurrentSince Jun 13, 2016 Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

Organizations & group practices 5

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649340175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060011029",
            "telephone_number": "860-651-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951722",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIV",
        "first_name": "ANNELIIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.