Individual provider Active NPI

Angela Andrade, LCSW

  • Clinical Social Worker
  • Durham, CT
National Provider Identifier
1811250632
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006601 Issued in CT
Practice address
459R Wallingford Rd
Durham, CT 06422-1124
Phone
(860) 349-1989
Fax
(860) 349-1982
NPI assigned
Jun 18, 2012
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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 006601 CT Primary

Addresses

Primary practice location

459R Wallingford Rd
Durham, CT 06422-1124

Mailing address

459R Wallingford Rd
Durham, CT 06422-1124
Phone (860) 349-1989

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006601CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1811250632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459R WALLINGFORD RD",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221124",
            "telephone_number": "860-349-1989",
            "fax_number": "860-349-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459R WALLINGFORD RD",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221124",
            "telephone_number": "860-349-1989",
            "fax_number": "860-349-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.