Active NPI
Melissa Ann Deangelis, LCSW
- Clinical Social Worker
- Norwich, CT
National Provider Identifier
1770659294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005351
- Practice address
- 401 West Thames Street BLDG 301
Southeastern Mental Health Authority
Norwich, CT 06360 - Phone
- (860) 859-4674
- Fax
- (860) 859-4790
- NPI assigned
- Nov 27, 2006
- 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 | 005351 | CT | Primary |
Addresses
Primary practice location
401 West Thames Street BLDG 301
Southeastern Mental Health Authority
Norwich, CT 06360
Mailing address
401 West Thames Street BLDG 301
Southeastern Mental Health Authority
Norwich, CT 06360
Phone (860) 859-4674
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005351 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770659294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 WEST THAMES STREET BLDG 301",
"address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY",
"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 WEST THAMES STREET BLDG 301",
"address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY",
"city": "NORWICH",
"state": "CT",
"postal_code": "06360",
"telephone_number": "860-859-4674",
"fax_number": "860-859-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANGELIS",
"first_name": "MELISSA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005351",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.