Individual provider Active NPI

Chelsea Poloski, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1790394575
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12329 Issued in CT
Practice address
386 Main Street
4TH and 5TH Floors
Middletown, CT 06457
Phone
(860) 578-8550
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 12329 CT Primary

Addresses

Primary practice location

386 Main Street
4TH and 5TH Floors
Middletown, CT 06457

Mailing address

386 Main Street
4TH and 5TH Floors
Middletown, CT 06457
Phone (860) 578-8550

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
I20221208002313 CT Practitioner - Clinical Social Worker 3375912603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12329CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Nov 16, 2022 Accepting new patients
Connecticut Children'S Specialty Group, Inc. CurrentSince Nov 16, 2022 Accepting new patients
And Therapy Collaborative LLC Clinical Current Accepting new patients

Locations

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

100 Retreat Ave
Fl 5
Hartford, CT 06106
Phone (860) 837-5206

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

386 Main St
Fl 4
Middletown, CT 06457
Phone (732) 630-0581

Interoperability endpoints

  • Direct secure messaging: chelsea.poloski@xdr.hhchealthdirect.org

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1790394575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 MAIN STREET",
            "address_2": "4TH AND 5TH FLOORS",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-578-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 MAIN STREET",
            "address_2": "4TH AND 5TH FLOORS",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-578-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLOSKI",
        "first_name": "CHELSEA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.