NPIMap

Organization Active NPI

Community Renewal Team

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1679748628
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006427 Issued in CT
Legal business name
COMMUNITY RENEWAL TEAM
Practice address
675 Tower Ave
Mob, Suite 308
Hartford, CT 06112-1273
Phone
(860) 714-9200
Fax
(860) 714-8516
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
Mrs. Patricia Pollicina
Title
Clinician
Phone
(860) 714-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 006427 CT Primary

Addresses

Primary practice location

675 Tower Ave
Mob, Suite 308
Hartford, CT 06112-1273

Mailing address

675 Tower Ave
Mob, Suite 308
Hartford, CT 06112-1273
Phone (860) 714-9200

Other identifiers 1

IdentifierTypeStateIssuer
004243747OtherCTBILLING PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Community Renewal Team7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

675 Tower Ave
Ste 308
Hartford, CT 06112
Phone (860) 714-2718

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1679748628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "MOB, SUITE 308",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-9200",
            "fax_number": "860-714-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "MOB, SUITE 308",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-9200",
            "fax_number": "860-714-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RENEWAL TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "POLLICINA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "860-714-9200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BILLING PROVIDER NUMBER",
            "identifier": "004243747",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.