Individual provider Active NPI

Corinne Walters, LCSW

  • Clinical Social Worker
  • Enfield, CT
National Provider Identifier
1871030247
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8949 Issued in CT
Practice address
5 N Main St
Enfield, CT 06082-3372
Phone
(860) 253-9024
Fax
(860) 253-9593
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 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 8949 CT Primary

Addresses

Primary practice location

5 N Main St
Enfield, CT 06082-3372

Mailing address

5 N Main St
Enfield, CT 06082-3372
Phone (860) 253-9024

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
I20240506001509 CT Practitioner - Clinical Social Worker 4688014780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8949CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc Clinical Current Accepting new patients
Community Health Center Inc CurrentSince Apr 26, 2024 Accepting new patients

Locations

5 N Main St
Enfield, CT 06082
Phone (860) 253-9024

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

Interoperability endpoints

  • Direct secure messaging: corinne.walters@chcict.eclinicaldirectplus.com

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1871030247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 N MAIN ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823372",
            "telephone_number": "860-253-9024",
            "fax_number": "860-253-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 N MAIN ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823372",
            "telephone_number": "860-253-9024",
            "fax_number": "860-253-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "CORINNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.