Individual provider Active NPI

Kristy Sonstroem, MSW, LCSW

  • Clinical Social Worker
  • West Springfield, MA
National Provider Identifier
1699256552
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010079 Issued in CT
Practice address
103 Myron St Ste a
West Springfield, MA 01089-1485
Phone
(413) 592-1980
Fax
(413) 439-0100
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 010079 CT Primary

Addresses

Primary practice location

103 Myron St Ste a
West Springfield, MA 01089-1485

Mailing address

103 Myron St Ste a
West Springfield, MA 01089-1485
Phone (413) 592-1980

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
I20180912002005 CT Practitioner - Clinical Social Worker 1456601400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Health Psych PCGroup PAC ID 6204248149, 20 clinicians

Practice addresses (Care Compare)

240 Indian River Rd
Suite C7
Orange, CT 06477-3691
Phone (203) 497-3867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10079CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Health P.C. CurrentSince Feb 1, 2020 Accepting new patients
Impact Health Psych PC CurrentSince Oct 1, 2020 Accepting new patients

Locations

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

Organizations & group practices 2

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1699256552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MYRON ST STE A",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891485",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MYRON ST STE A",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891485",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONSTROEM",
        "first_name": "KRISTY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.