Safiya Lorriana Ruddock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

100 Market SQ
Newington, CT 06111-2921

Phone

(860) 554-4194

NPI assigned

Nov 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: safiya.ruddock.p1@direct.wheelerclinic.nextgenshare.com

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.

• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Middletown, CT
  • NPI 1427074426
  Medicare reassignment NPD
• Insightful Solutions LLC

  • Adult Mental Health Clinic/Center
  • Newington, CT
  • NPI 1427626068
  NPD Authorized official
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1811361702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2275",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064570032",
            "telephone_number": "860-878-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKET SQ",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112921",
            "telephone_number": "860-554-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDOCK",
        "first_name": "SAFIYA",
        "middle_name": "LORRIANA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "009734",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Bohn Rotell, PT, DPT
• Stacey Krysten Rothstein, MS PT
• John Roy
• Nicole Elizabeth Roy
• Steven Roy
• Katelyn Russell
• Joseph Francis Ryan, A.S.
• Aysha Saeed, MD
• Safe Passages LLC
• Katherine Saia, OTR/L

• Clinical Social Worker in Newington, CT
• Providers in Newington, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.