Maritza Angulo de Gonzalez, LCSW

Individual provider Active NPI Clinical Social Worker · Hartford, CT

NPI 1750311981 · NPPES record last updated May 26, 2010

Key facts

NPI
1750311981
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
004597 (CT)
Practice address
48 Storrs St
Hartford, CT 06106-4258
Phone
(860) 965-0635
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
004597CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Straun Health & Wellness Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maritza.angulo.de.gonzalez.1@23172.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23172/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 004597 CT Yes

Addresses

Primary practice location

48 Storrs St
Hartford, CT 06106-4258

Mailing address

48 Storrs St
Hartford, CT 06106-4258
Phone (860) 965-0635

Other identifiers

IdentifierTypeStateIssuer
321636OtherCTMHN
7819545OtherCTAETNA
004234952MedicaidCT
494566OtherCTVALUE OPTIONS
140004597CT01OtherCTANTHEM BCBS
398612OtherCTMAGELLAN BEHAVIORAL HEALT

Other providers in Hartford, CT

All providers in Hartford, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.