Candace I Boden, LCSW

Individual provider Active NPI Clinical Social Worker · Litchfield, CT

NPI 1689688673 · NPPES record last updated May 13, 2013

Key facts

NPI
1689688673
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
004074 (CT)
Practice address
89 Richards Rd
Litchfield, CT 06759-3701
Phone
(860) 567-7792
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

89 Richards Rd
Litchfield, CT 06759-3701
Phone (860) 567-7792

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20071226000160 CT Practitioner - Clinical Social Worker 9436249752 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4074CTMDHealth Service Psychologist
004074CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boden Counseling LLC Clinical Current
since Dec 26, 2007
Accepting new patients
Catholic Charities, Inc. - Archdiocese of Hartford Past
since Jan 1, 2000
Accepting new patients
Catholic Charities, Inc. - Archdiocese of Hartford Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/ccaoh/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 004074 CT Yes

Addresses

Primary practice location

89 Richards Rd
Litchfield, CT 06759-3701

Mailing address

89 Richards Rd
Litchfield, CT 06759-3701
Phone (860) 567-7792

Other identifiers

IdentifierTypeStateIssuer
004258382MedicaidCT

Other providers in Litchfield, CT

All providers in Litchfield, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.