Active NPI
Michelle Lynn Degennaro
- Social Worker
- Glastonbury, CT
National Provider Identifier
1851931117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4865
- Practice address
- 110 National Drive
Glastonbury, CT 06033 - Phone
- (860) 657-8910
- NPI assigned
- Jan 14, 2020
- Last updated
- Jan 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4865 | CT | Primary |
Addresses
Primary practice location
110 National Drive
Glastonbury, CT 06033
Mailing address
110 National Drive
Glastonbury, CT 06033
Phone (860) 657-8910
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
56 Vina Lane
Brooklyn, CT 06234-1937
Phone (914) 693-2190
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4865 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Living Behavioral Health LCSW PLLC | Current | Accepting new patients | |
| Awaken Hope Within LLC | Current | Accepting new patients |
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.
-
- Mental Health Counselor
- Windsor, CT
- NPI 1801682539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1851931117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 NATIONAL DRIVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-657-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 NATIONAL DRIVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-657-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENNARO",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-14",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "4865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.