Individual provider Active NPI

Christine Marie Conway

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1730946336
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
013496 Issued in CT
Practice address
235 Nicoll St
New Haven, CT 06511-2670
Phone
(203) 624-2600
NPI assigned
Mar 1, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 013496 CT Primary

Addresses

Primary practice location

235 Nicoll St
New Haven, CT 06511-2670

Mailing address

350 Bucks Hill Rd
Southbury, CT 06488-1830
Phone (475) 204-7651

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
I20251028002024 CT Practitioner - Clinical Social Worker 1456840776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southbury Adolescent and Young Adult Counseling CenterGroup PAC ID 5193221349, 15 clinicians

Practice addresses (Care Compare)

519 Heritage Rd
Suite 2A5
Southbury, CT 06488-6694
Phone (203) 568-5923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013496CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southbury Adolescent and Young Adult Counseling Center Clinical CurrentSince Aug 18, 2025 Accepting new patients
Family Centered Services of CT Clinical PastSince Mar 3, 2024 Accepting new patients

Locations

519 Heritage Rd
Ste 2A5
Southbury, CT 06488
Phone (203) 568-5923

26 N Main St
Ste 2A
Southington, CT 06489
Phone (203) 568-5923

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": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1730946336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BUCKS HILL RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064881830",
            "telephone_number": "475-204-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NICOLL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112670",
            "telephone_number": "203-624-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "013496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.