Individual provider Active NPI

Chester J. Brodnicki, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1679774194
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001889 Issued in CT
Practice address
93 Edwards St
New Haven, CT 06511-3933
Phone
(203) 772-1270
Fax
(203) 772-0051
NPI assigned
May 31, 2007
Sex
Male
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 001889 CT Primary

Addresses

Primary practice location

93 Edwards St
New Haven, CT 06511-3933

Mailing address

59 Arnoldale Rd
West Hartford, CT 06119-1717
Phone (860) 236-3050

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

LicenseStateTypeSpecialty
001889CTMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679774194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ARNOLDALE RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191717",
            "telephone_number": "860-236-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 EDWARDS ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113933",
            "telephone_number": "203-772-1270",
            "fax_number": "203-772-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODNICKI",
        "first_name": "CHESTER",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.