Alice Mary Simoniello

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003869 Issued in CT

Practice address

60 Hicksville Rd
Cromwell, CT 06416-2409

Phone

(860) 635-6010

Fax

(860) 635-3425

NPI assigned

Aug 8, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Alice Mary McKeon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• The Children'S Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Cromwell, CT
  • NPI 1710216163
  NPD (past)

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1841622263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HICKSVILLE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162409",
            "telephone_number": "860-635-6010",
            "fax_number": "860-635-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HICKSVILLE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162409",
            "telephone_number": "860-635-6010",
            "fax_number": "860-635-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONIELLO",
        "first_name": "ALICE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISENCED CLINICAL SOCIAL WORKER",
            "identifier": "003869",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "MCKEON",
            "middle_name": "MARY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert M Shortell, D.C.
• Jeffrey M. Shuster, D.D.S.
• Bryne-Marie Sidney, MS CCC-SLP
• Stephen J Siegel, MD
• Whitney Simmons, LPC
• Teno Simpson
• Margaret Skelly
• Katrina Skroupa, PHARMD
• Katherine Sluti
• Sydney Jewel Smallwood, OTD,OTR/L

• Clinical Social Worker in Cromwell, CT
• Providers in Cromwell, 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 Aug 8, 2013; 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.