Active NPI
Breakthrough Clinical Services
- Clinical Social Worker
- Windsor, CT
National Provider Identifier
1871982967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 008665
- Legal business name
- BREAKTHROUGH CLINICAL SERVICES
- Practice address
- 360 Bloomfield Ave
Ste 301
Windsor, CT 06095-2700 - Phone
- (860) 597-7504
- NPI assigned
- Jan 13, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Velanda Samuel, LCSW
- Title
- Owner
- Phone
- (860) 597-7504
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 008665 | CT | Primary |
Addresses
Primary practice location
360 Bloomfield Ave
Ste 301
Windsor, CT 06095-2700
Mailing address
72 Briarwood Dr
Windsor, CT 06095-3937
Phone (860) 597-7504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170320002392 | CT | Part B Supplier - Clinic/Group Practice | 4587949276 |
Receives reassigned benefits from 1 practitioner Practice locations: Windsor, CT |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1488499200000",
"number": "1871982967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 BRIARWOOD DR",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060953937",
"telephone_number": "860-597-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 BLOOMFIELD AVE",
"address_2": "STE 301",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952700",
"telephone_number": "860-597-7504"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BREAKTHROUGH CLINICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-13",
"last_updated": "2017-03-03",
"status": "A",
"authorized_official_last_name": "SAMUEL",
"authorized_official_first_name": "VELANDA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "860-597-7504",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "008665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.