Individual provider Active NPI

Madison McNally Dahm, MSW, LCSW

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1700407905
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10327 Issued in CT
Practice address
5 Founders St Ste 100
Willimantic, CT 06226-2049
Phone
(860) 423-9764
Fax
(860) 423-3115
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 10327 CT Primary

Addresses

Primary practice location

5 Founders St Ste 100
Willimantic, CT 06226-2049

Mailing address

39 Macht Rd
Columbia, CT 06237-1109
Phone (860) 334-3888

Other names 1

  • Madison Leigh McNally Former name

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
I20210421002951 CT Practitioner - Clinical Social Worker 3779991245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

5 Founders St
Suite 100
Willimantic, CT 06226-2049
Phone (860) 423-9764

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10327CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Apr 15, 2024 Accepting new patients
Natchaug Hospital, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

934 N Main St
Danielson, CT 06239
Phone (860) 779-2101

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

5 Founders St
Ste 100
Willimantic, CT 06226
Phone (860) 423-9764

Interoperability endpoints

  • Direct secure messaging: madison.dahm@xdr.hhchealthdirect.org

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": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1700407905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MACHT RD",
            "city": "COLUMBIA",
            "state": "CT",
            "postal_code": "062371109",
            "telephone_number": "860-334-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FOUNDERS ST STE 100",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262049",
            "telephone_number": "860-423-9764",
            "fax_number": "860-423-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHM",
        "first_name": "MADISON",
        "middle_name": "MCNALLY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "MCNALLY",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.