Active NPI
Yvonne Evangelista Acosta- Martinez, LCSW
- Clinical Social Worker
- Hartford, CT
National Provider Identifier
1700979440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 03770
- Practice address
- 151 New Park Ave Unit 31
Hartford, CT 06106-2181 - Phone
- (860) 292-3082
- Fax
- (860) 293-0828
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 03770 | CT | Primary |
Addresses
Primary practice location
151 New Park Ave Unit 31
Hartford, CT 06106-2181
Mailing address
555 Frankliin Ave.
Hartford, CT 06114
Phone (860) 292-3082
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070123000423 | CT | Practitioner - Clinical Social Worker | 5193726859 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03770 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Community Mental Health Center Inc. | Current | Accepting new patients | |
| Full Circle LLC | Past | Accepting new patients |
Locations
2550 Main St
Hartford, CT 06120
Phone (860) 548-0101
2550 Main St
Fl 3
Hartford, CT 06120
Phone (860) 548-0101
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hartford, CT
- NPI 1972592186
CT
-
- Mental Health Counselor
- Hartford, CT
- NPI 1578289039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1700979440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 FRANKLIIN AVE.",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06114",
"telephone_number": "860-292-3082",
"fax_number": "860-293-0828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 NEW PARK AVE UNIT 31",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061062181",
"telephone_number": "860-292-3082",
"fax_number": "860-293-0828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOSTA- MARTINEZ",
"first_name": "YVONNE",
"middle_name": "EVANGELISTA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "03770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.