Individual provider Active NPI

Mary Lou Oates, LCSW

  • Clinical Social Worker
  • Milford, CT
National Provider Identifier
1811935497
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002989 Issued in CT
Practice address
949 Bridgeport Ave
Milford, CT 06460-3142
Phone
(203) 878-6365
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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 002989 CT Primary

Addresses

Primary practice location

949 Bridgeport Ave
Milford, CT 06460-3142

Mailing address

32 Judson Cir
Shelton, CT 06484-4611
Phone (203) 929-5443

Other identifiers 2

IdentifierTypeStateIssuer
005989OtherCTSOCIAL WORK LICENSE
004039244MedicaidCT

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
I20060425000301 CT Practitioner - Clinical Social Worker 7012927866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Griffin HospitalGroup PAC ID 8921901984, 24 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-7360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002989CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Griffin Hospital CurrentSince Jul 6, 2015 Accepting new patients

Locations

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

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1811935497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 JUDSON CIR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844611",
            "telephone_number": "203-929-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 BRIDGEPORT AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603142",
            "telephone_number": "203-878-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OATES",
        "first_name": "MARY LOU",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "005989",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004039244",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.