Active NPI
Paula M Mekkelsen, LCSW
- Clinical Social Worker
- Groton, CT
National Provider Identifier
1710076419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 002005
- Practice address
- 1057 Poquonnock Rd
Groton, CT 06340-6630 - Phone
- (860) 857-8044
- Fax
- (860) 437-1190
- NPI assigned
- Oct 12, 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 | 002005 | CT | Primary |
Addresses
Primary practice location
1057 Poquonnock Rd
Groton, CT 06340-6630
Mailing address
1057 Poquonnock Rd
Groton, CT 06340-6630
Phone (860) 857-8044
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
41 Faire Harbour PL
New London, CT 06320-4710
Phone (860) 437-6914
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002005 | CT | MD | Clinical Social Worker |
| 2005 | CT | MD | Physical Therapy Assistant |
Interoperability endpoints
- paula.mekkelsen.1@32885.direct.athenahealth.com
Organizations & group practices 1
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)
- New London, CT
- NPI 1629158126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550880000000",
"number": "1710076419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 POQUONNOCK RD",
"city": "GROTON",
"state": "CT",
"postal_code": "063406630",
"telephone_number": "860-857-8044",
"fax_number": "860-437-1190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1057 POQUONNOCK RD",
"city": "GROTON",
"state": "CT",
"postal_code": "063406630",
"telephone_number": "860-857-8044",
"fax_number": "860-437-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEKKELSEN",
"first_name": "PAULA",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2019-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "002005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.