Individual provider Active NPI

Nelle Elizabeth Manuel, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1811392830
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007884 Issued in CT
Practice address
372 Central Ave
New Haven, CT 06515-2250
Phone
(203) 430-3507
NPI assigned
Nov 3, 2014
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 007884 CT Primary

Addresses

Primary practice location

372 Central Ave
New Haven, CT 06515-2250

Mailing address

372 Central Ave
New Haven, CT 06515-2250
Phone (203) 430-3507

Other practice location 1

110 Commerce Dr
Shelton, CT 06484-6244
Phone (203) 929-7331

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
I20200129000303 CT Practitioner - Clinical Social Worker 8123454873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1330

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007884CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Griffin Hospital CurrentSince Dec 9, 2019 Accepting new patients
Griffin Faculty Physicians, Inc. CurrentSince Jul 1, 2020 Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

110 Commerce Dr
Shelton, CT 06484
Phone (203) 426-5554

Interoperability endpoints

  • Direct secure messaging: nelle.manuel.1@1323.direct.athenahealth.com

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": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1811392830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 CENTRAL AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065152250",
            "telephone_number": "203-430-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 CENTRAL AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065152250",
            "telephone_number": "203-430-3507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846244",
            "country_code": "US",
            "telephone_number": "203-929-7331",
            "fax_number": "203-925-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "NELLE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.