Kelly M Radocchia, LCSW, LADC, CAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004939 Issued in CT

Practice address

140 Glastonbury Blvd
Suite 25
Glastonbury, CT 06033-4402

Phone

(860) 644-0300

NPI assigned

Mar 5, 2012

Last updated

Mar 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 8, 2016 through Jun 8, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapeutic Collaborations, LLC

  • Clinical Social Worker
  • Glastonbury, CT
  • NPI 1104190404
  NPD (past) Authorized official

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1831463132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 OAKLAND RD",
            "address_2": "UNIT 106",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742866",
            "telephone_number": "860-646-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GLASTONBURY BLVD",
            "address_2": "SUITE 25",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334402",
            "telephone_number": "860-644-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOCCHIA",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LCSW, LADC, CAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Quimby
• Sandra H Quinn, LPC
• Deborah Radcliffe, LCSW
• Laura Radin, PH.D.
• Radiology Associates of Hartford PLLC
• Nicole Rafala
• Christine A Ragusa, LMFT RD
• Danielle Ramin, OTR/L
• Rebecca L Randazzo, APRN
• Jeffrey David Rapp, LMSW

• Clinical Social Worker in Glastonbury, CT
• Providers in Glastonbury, 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 Mar 5, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.