Individual provider Active NPI

Brandi Kennedy, MSW

  • Clinical Social Worker
  • Essex, CT
National Provider Identifier
1801535505
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
190 Westbrook Rd
Essex, CT 06426-1518
Phone
(860) 437-4550
NPI assigned
Jun 1, 2022
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

190 Westbrook Rd
Essex, CT 06426-1518

Mailing address

7 Vauxhall St
New London, CT 06320-5711
Phone (860) 437-4550

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
I20240919000804 CT Practitioner - Clinical Social Worker 8921549858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Village for Families & Children, Inc. CurrentSince Jul 7, 2024 Accepting new patients
Pathways to Perseverance LLC Clinical Past Accepting new patients

Locations

1680 Albany Ave
Hartford, CT 06105
Phone (860) 236-4511

331 Wethersfield Ave
Hartford, CT 06114
Phone (860) 236-4511

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.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1801535505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 VAUXHALL ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205711",
            "telephone_number": "860-437-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WESTBROOK RD",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261518",
            "telephone_number": "860-437-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRANDI",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

Verify at the official NPI Registry.