Individual provider Active NPI

Sherri Carolino, LCSW, LADC

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1750399176
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005757 Issued in CT
Practice address
141 E Main St
Waterbury, CT 06702-2310
Phone
(203) 597-1935
Fax
(203) 597-8711
NPI assigned
Aug 3, 2006
Last updated
Sep 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000767 CT
Clinical Social Worker 1041C0700X 005757 CT Primary

Addresses

Primary practice location

141 E Main St
Waterbury, CT 06702-2310

Mailing address

141 E Main St
Waterbury, CT 06702-2310
Phone (203) 597-1935

Other identifiers 2

IdentifierTypeStateIssuer
008050379MedicaidCT
004236338MedicaidCT

Other names 1

  • Sherri Mengual Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000767CTMDOccupational Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grateful Soul Counseling, LLC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sherri.carolino@chcict.eclinicaldirectplus.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, 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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1750399176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-597-1935",
            "fax_number": "203-597-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-597-1935",
            "fax_number": "203-597-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLINO",
        "first_name": "SHERRI",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000767",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008050379",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236338",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRI",
            "last_name": "MENGUAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.