Individual provider Active NPI

Yvonne Evangelista Acosta- Martinez, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1700979440
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
03770 Issued in CT
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

Updated by the provider on Sep 18, 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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070123000423 CT Practitioner - Clinical Social Worker 5193726859 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03770CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Community Mental Health Center Inc. CurrentSince Jul 8, 2017 Accepting new patients
Full Circle LLC PastSince Apr 2, 2018 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.

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

Verify at the official NPI Registry.