Active NPI
Robert J Fayle, LCSW
- Clinical Social Worker
- West Hartford, CT
National Provider Identifier
1730408980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 009396
- Practice address
- 1100 New Britain Ave Ste 201
West Hartford, CT 06110-2447 - Phone
- (860) 970-7624
- NPI assigned
- May 27, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 009396 | CT | Primary |
Addresses
Primary practice location
1100 New Britain Ave Ste 201
West Hartford, CT 06110-2447
Mailing address
354 Birch Mountain Rd
Glastonbury, CT 06033
Phone (860) 970-7624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009396 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1730408980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "354 BIRCH MOUNTAIN RD",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-970-7624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 NEW BRITAIN AVE STE 201",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061102447",
"telephone_number": "860-970-7624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAYLE",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-27",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "009396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.