Shawna Salce-Pellerin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11496 Issued in CT

Practice address

202 Pomfret St
Putnam, CT 06260-1833

Phone

(860) 774-7501

NPI assigned

Jun 4, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1871160390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-774-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCE-PELLERIN",
        "first_name": "SHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008103133",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Roy, RD
• Susan Ann Rudeen, OTR/L
• Erin Russell
• Anthony Rutledge, ND
• Michelle Saez, RN
• Benjamin Salois, L.O.
• Jennifer Salvas
• Cynthia L Samokar, LMSW
• Gurkirat Singh Sandhu, M.D.
• Vanmaly P. Sangasy

• Clinical Social Worker in Putnam, CT
• Providers in Putnam, 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 Aug 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.