Individual provider Active NPI

Rebecca Susan Scandell, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1760636542
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4 Science Park
New Haven, CT 06511-1962
Phone
(184) 483-0723
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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 Primary

Addresses

Primary practice location

4 Science Park
New Haven, CT 06511-1962

Mailing address

76 Julie Dr
Glen Carbon, IL 62034-3007
Phone (618) 288-2811

Other names 1

  • Ms. Rebecca Susan Miller Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laurie@ouitherapeutics.com Health Information Exchange (HIE) Vita Health Services, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20090814000642 IL Practitioner - Clinical Social Worker 0547314288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

206 N Randolph St
2ND Floor Private Office 246
Champaign, IL 61820-3976
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Health Services, LLPC Clinical CurrentSince Oct 10, 2021 Accepting new patients
Vita Health Services, PLLC Clinical PastSince Apr 1, 2022 Accepting new patients

Locations

4 Science Park
New Haven, CT 06511
Phone (203) 498-9706

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24036/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1760636542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 JULIE DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343007",
            "telephone_number": "618-288-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SCIENCE PARK",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111962",
            "telephone_number": "184-483-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANDELL",
        "first_name": "REBECCA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laurie@ouitherapeutics.com",
            "affiliation": "Y",
            "affiliationName": "Vita Health Services, PLLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Science Park",
            "city": "New Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065111962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "MILLER",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.