Individual provider Active NPI

Brian Garrett Lane, LCSW

  • Clinical Social Worker
  • Bloomfield, CT
National Provider Identifier
1689744062
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6808 Issued in CT
Practice address
699 Bloomfield Ave
Bloomfield, CT 06002-2462
Phone
(860) 392-9990
Fax
(860) 243-6591
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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 6808 CT Primary

Addresses

Primary practice location

699 Bloomfield Ave
Bloomfield, CT 06002-2462

Mailing address

699 Bloomfield Ave
Bloomfield, CT 06002-2462
Phone (860) 392-9990

Other identifiers 1

IdentifierTypeStateIssuer
WSW22474BOtherCAMEDICARE PPIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090213000168 CT Practitioner - Clinical Social Worker 5698700920 Practice locations: Bloomfield, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

699 Bloomfield Ave
Bloomfield, CT 06002-2462
Phone (860) 392-9990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6808CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safely Speaking, PLLC PastSince Dec 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1689744062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022462",
            "telephone_number": "860-392-9990",
            "fax_number": "860-243-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022462",
            "telephone_number": "860-392-9990",
            "fax_number": "860-243-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "BRIAN",
        "middle_name": "GARRETT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "6808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PPIN",
            "identifier": "WSW22474B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.