Individual provider Active NPI

Kendra Lakelle Toodle-Register, LCSW

  • Clinical Social Worker
  • Manchester, CT
National Provider Identifier
1710633722
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11989 Issued in CT
Practice address
153 Kent Dr
Manchester, CT 06042-2258
Phone
(860) 810-8510
NPI assigned
Feb 28, 2022
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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 11989 CT Primary

Addresses

Primary practice location

153 Kent Dr
Manchester, CT 06042-2258

Mailing address

153 Kent Dr
Manchester, CT 06042-2258
Phone (860) 810-8510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230417000684 CT Practitioner - Clinical Social Worker 1052797784 Reassigns benefits to 2 organizations
I20240515003607 OH Practitioner - Clinical Social Worker 1052797784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5647CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Zen Wellness Care Clinical CurrentSince Dec 31, 2022 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 3, 2024 Accepting new patients

Locations

699 Bloomfield Ave
Ste 205
Bloomfield, CT 06002
Phone (860) 265-9309

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

660 Prospect Ave
Ste 100
Hartford, CT 06105
Phone (860) 999-4431

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1710633722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 KENT DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422258",
            "telephone_number": "860-810-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 KENT DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422258",
            "telephone_number": "860-810-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOODLE-REGISTER",
        "first_name": "KENDRA",
        "middle_name": "LAKELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.