Active NPI
Melissa Procaccini
- Specialist
- Tolland, CT
National Provider Identifier
1669875357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 001326
- Practice address
- 26 Shenipsit Lake Rd
Tolland, CT 06084-2332 - Phone
- (860) 872-2999
- NPI assigned
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 001326 | CT | Primary |
Addresses
Primary practice location
26 Shenipsit Lake Rd
Tolland, CT 06084-2332
Mailing address
26 Shenipsit Lake Rd
Tolland, CT 06084-2332
Phone (860) 872-2999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001326 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1669875357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 SHENIPSIT LAKE RD",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060842332",
"telephone_number": "860-872-2999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 SHENIPSIT LAKE RD",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060842332",
"telephone_number": "860-872-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCACCINI",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CT",
"license": "001326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolland, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.