Shona K Maddocks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007993 Issued in CT

Practice address

40 Bolivia St
Willimantic, CT 06226-2843

Phone

(860) 455-8648

Fax

(860) 423-5353

NPI assigned

Nov 18, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Parham Counseling Services, LLC

  • Mental Health Counselor
  • Norwich, CT
  • NPI 1750893905
  NPD
• New England Center for Health and Nutrition LLC

  • Medical Specialty Clinic/Center
  • Ashford, CT
  • NPI 1457866485
  NPD (past)
• The Connection Inc.

  • Adult Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1992823538
  NPD (past)

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1669627683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BOLIVIA ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262843",
            "telephone_number": "860-455-8648",
            "fax_number": "860-423-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BOLIVIA ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262843",
            "telephone_number": "860-455-8648",
            "fax_number": "860-423-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOCKS",
        "first_name": "SHONA",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-18",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Lopez, LCSW
• Azra Lupacchino, LPC
• Virginia Lyon, LCSW
• Vincent I. Macandrew Jr., M.D.
• Gina K Maccarone, RN
• Bernice V Malachi
• Susan J. Mancuso, OTR
• Matthew E Mannarino, LCSW
• Mansfield Cardiovascular Care LLC
• Jacqueline Mary Manthous

• Clinical Social Worker in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.