Individual provider Active NPI

Marlanda Hamilton

  • Clinical Social Worker
  • Mansfield Center, CT
National Provider Identifier
1780197988
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
7B Ledgebrook Dr
Mansfield Center, CT 06250-1664
Phone
(860) 731-5522
NPI assigned
Nov 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 004069 CT
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

7B Ledgebrook Dr
Mansfield Center, CT 06250-1664

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522

Other practice location 1

1491 Main St
Willimantic, CT 06226-1914
Phone (860) 456-3215

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
I20200820003074 CT Practitioner - Clinical Social Worker 7810313889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

90 S Main St
Middletown, CT 06457-3649
Phone (860) 358-3401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004069CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Oct 19, 2020 Accepting new patients
Community Health Resources, Inc. CurrentSince Jun 10, 2020 Accepting new patients
Middlesex Hospital CurrentSince Oct 19, 2020 Accepting new patients

Locations

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

7B Ledgebrook Dr
Mansfield Center, CT 06250
Phone (860) 456-0038

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351

2 Waterside Xing
Ste 401
Windsor, CT 06095

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1780197988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7B LEDGEBROOK DR",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501664",
            "telephone_number": "860-731-5522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1491 Main St",
            "address_purpose": "LOCATION",
            "city": "Willimantic",
            "state": "CT",
            "postal_code": "062261914",
            "country_code": "US",
            "telephone_number": "860-456-3215",
            "fax_number": "860-423-3351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARLANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "004069",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield Center, CT

Sources for this page

Verify at the official NPI Registry.