Active NPI
Fanny Elena Aguilar, LCSW
- Clinical Social Worker
- Norwich, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 007589
- 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
- Last updated
- Oct 1, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007589 | CT | Primary |
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
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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
Organizations & group practices 2
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.
-
dba Southeastern Mental Health Authority
- Adult Mental Health Clinic/Center
- Norwich, CT
- NPI 1902831548
-
dba Department of Veterans' Affairs, Veterans Home
- Skilled Nursing Facility
- Rocky Hill, CT
- NPI 1205951662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1760733786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W. THAMES ST",
"address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY, BLDG 301",
"city": "NORWICH",
"state": "CT",
"postal_code": "06360",
"telephone_number": "860-859-4674",
"fax_number": "860-859-4790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W. THAMES ST.",
"address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY, BLDG 301",
"city": "NORWICH",
"state": "CT",
"postal_code": "06360",
"telephone_number": "860-859-4674",
"fax_number": "860-859-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGUILAR",
"first_name": "FANNY",
"middle_name": "ELENA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-01",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "007589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.