Individual provider Active NPI

Dennis Aurel Goguen, MSW, LCSW

  • Clinical Social Worker
  • Groton, CT
National Provider Identifier
1851339782
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006063 Issued in CT
Practice address
428 Long Hill Rd
Groton, CT 06340-3811
Phone
(860) 391-6049
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 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 006063 CT Primary

Addresses

Primary practice location

428 Long Hill Rd
Groton, CT 06340-3811

Mailing address

95 Liberty St
Clinton, CT 06413-2418
Phone (860) 304-2382

Other practice location 1

47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042

Other practice location 2

591 Poquonnock Rd
Groton, CT 06340-4571
Phone (860) 449-8217

Other practice location 3

95 Liberty St
Clinton, CT 06413
Phone (860) 304-2382

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
I20060612000092 CT Practitioner - Clinical Social Worker 1456340074 Practice locations: Groton, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7087WIMDOccupational Therapy Assistant
006063CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Gardner-Flores, LCSW, LLC Clinical CurrentSince Oct 4, 2020 Accepting new patients
Edda McManus LCSW LLC Clinical Past Accepting new patients

Locations

428 Long Hill Rd
Fl 2
Groton, CT 06340
Phone (860) 304-2382

428 Long Hill Rd
Groton, CT 06340
Phone (860) 304-2382

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 and National Provider Directory roles.

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": "1601078400000",
    "number": "1851339782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 LIBERTY ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132418",
            "telephone_number": "860-304-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 LONG HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403811",
            "telephone_number": "860-391-6049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Town St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602315",
            "country_code": "US",
            "telephone_number": "860-892-7042",
            "fax_number": "860-892-7043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "591 Poquonnock Rd",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "CT",
            "postal_code": "063404571",
            "country_code": "US",
            "telephone_number": "860-449-8217",
            "fax_number": "860-449-8217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 Liberty St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "CT",
            "postal_code": "06413",
            "country_code": "US",
            "telephone_number": "860-304-2382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOGUEN",
        "first_name": "DENNIS",
        "middle_name": "AUREL",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.