Individual provider Active NPI

Robert A Salcedo, LCSW

  • Clinical Social Worker
  • Columbia, CT
National Provider Identifier
1750496162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004242 Issued in CT
Practice address
219 Route 66
Columbia, CT 06237-1420
Phone
(860) 228-9033
Fax
(860) 228-9033
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 004242 CT Primary

Addresses

Primary practice location

219 Route 66
Columbia, CT 06237-1420

Mailing address

219 Route 66
Columbia, CT 06237-1420
Phone (860) 228-9033

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
I20120301000378 CT Practitioner - Clinical Social Worker 1456519933 Practice locations: Columbia, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

219 Route 66
Columbia, CT 06237-1420
Phone (860) 228-9033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004242CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750496162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 ROUTE 66",
            "city": "COLUMBIA",
            "state": "CT",
            "postal_code": "062371420",
            "telephone_number": "860-228-9033",
            "fax_number": "860-228-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 ROUTE 66",
            "city": "COLUMBIA",
            "state": "CT",
            "postal_code": "062371420",
            "telephone_number": "860-228-9033",
            "fax_number": "860-228-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCEDO",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, CT

Sources for this page

Verify at the official NPI Registry.