Individual provider Active NPI

Fannie Hardy, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1699319640
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003735 Issued in CT
Practice address
116 Sherman Ave
New Haven, CT 06511-5204
Phone
(203) 439-5555
NPI assigned
Nov 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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 003735 CT Primary

Addresses

Primary practice location

116 Sherman Ave
New Haven, CT 06511-5204

Mailing address

419 Whalley Ave
New Haven, CT 06511-3019
Phone (203) 439-5555

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
I20220505000756 CT Practitioner - Clinical Social Worker 6709273063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003735CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Behavioral Health and Community Services LLC Clinical CurrentSince Apr 7, 2022 Accepting new patients
Effective Community Services TLC LLC Clinical CurrentSince Feb 23, 2024 Accepting new patients
Effective Community Services TLC PastSince Oct 9, 2022 Accepting new patients

Locations

419 Whalley Ave
Fl 1
New Haven, CT 06511
Phone (203) 439-5555

116 Sherman Ave
New Haven, CT 06511
Phone (203) 439-5555

419 Whalley Ave
Ste 101
New Haven, CT 06511
Phone (203) 439-5555

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.

NPI Registry JSON

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

{
    "created_epoch": "1572739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1699319640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 WHALLEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113019",
            "telephone_number": "203-439-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SHERMAN AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115204",
            "telephone_number": "203-439-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "FANNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-03",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.