Fanny Elena Aguilar, LCSW
Individual provider Active NPI Clinical Social Worker · Norwich, CT
NPI 1760733786 · NPPES record last updated Oct 1, 2012
Key facts
- NPI
- 1760733786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 007589 (CT)
- Practice address
- 401 W. Thames St.
Southeastern Mental Health Authority, BLDG 301
Norwich, CT 06360 - Phone
- (860) 859-4674
- Fax
- (860) 859-4790
- NPI assigned
- Oct 1, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130725000845 | CT | Practitioner - Clinical Social Worker | 6901047414 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007589 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Current |
Accepting new patients | |
| State of Connecticut | Current |
Accepting new patients |
Locations
450 Columbus Blvd
Ste 1001
Hartford, CT 06103
401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007589 | CT | Yes |
Addresses
Primary practice location
401 W. Thames St.
Southeastern Mental Health Authority, BLDG 301
Norwich, CT 06360
Mailing address
401 W. Thames St
Southeastern Mental Health Authority, BLDG 301
Norwich, CT 06360
Phone (860) 859-4674
Other providers in Norwich, CT
- Advanced Community Support, LLC
- Advanced Dermatology LLC
- Advantage Dental Group, LLC
- Affinity Behavioral Health, LLC
- Lena Maria Aglio
- Eva M Ahern
- Amir Ahmad
- Natasha Selene Ahmad
- Aasiya Ahmed
- Mahfuza Akhtar
All providers in Norwich, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.