Mariah Concannon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

458 Grand Ave
New Haven, CT 06513-3856

Phone

(203) 752-1212

NPI assigned

May 27, 2022

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: mariah.concannon.p1@direct.wheelerclinic.nextgenshare.com

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.

• Wheeler Clinic

  • Case Management Agency
  • New Haven, CT
  • NPI 1700320629
  NPD (past)

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1861131930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 MANZONI FARM DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431966",
            "telephone_number": "203-710-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133856",
            "telephone_number": "203-752-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "MARIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Health Pharmacy LLC (Community Health Pharmacy)
• Complete Foot Care, LLC
• Griselle Compres
• Larry D Conaway, LCSW
• Mary Kathleen Conboy, DMD
• Concentra Health Services, Inc. (Concentra Medical Center)
• Caitlin Condon, OTR/L
• David Christopher Cone, MD
• Giulia Conley, PHARMD, BCPS
• Julie Anne Conley, M.S.

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, 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 May 27, 2022; 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.