Individual provider Active NPI

Carleigh Glynn Hannah, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1851934947
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9809 Issued in CT
Practice address
401 W Thames St BLDG 301
Norwich, CT 06360-7155
Phone
(860) 859-4510
Fax
(860) 859-4672
NPI assigned
Oct 22, 2019
Last updated
Oct 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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 9809 CT Primary

Addresses

Primary practice location

401 W Thames St BLDG 301
Norwich, CT 06360-7155

Mailing address

401 W Thames St BLDG 301
Norwich, CT 06360-7155
Phone (860) 859-4510

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
I20191111001839 CT Practitioner - Clinical Social Worker 9739511817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9809CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Oct 1, 2019 Accepting new patients
State of Connecticut CurrentSince Oct 1, 2019 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

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.

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1851934947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W THAMES ST BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607155",
            "telephone_number": "860-859-4510",
            "fax_number": "860-859-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W THAMES ST BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063607155",
            "telephone_number": "860-859-4510",
            "fax_number": "860-859-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "CARLEIGH",
        "middle_name": "GLYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.