Active NPI
Emily A Randall, LCSW
- Clinical Social Worker
- Waterbury, CT
National Provider Identifier
1881002368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 141 E Main St
Waterbury, CT 06702-2310 - Phone
- (203) 574-9000
- Fax
- (203) 574-9006
- NPI assigned
- Jul 28, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2218 | CT | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
141 E Main St
Waterbury, CT 06702-2310
Mailing address
2 Old New Milford Road
Suite 1-B
Brookfield, CT 06804
Phone (203) 775-2583
Other practice location 1
2 Old New Milford Road
Suite 1-B
Brookfield, CT 06804
Phone (203) 775-2583
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060669107 | Other | CT | HEALTHYCT WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| 13671806 | Other | CT | CAQH |
| PENDING | Medicaid | CT | |
| 060669107 | Other | CT | ANTHEM BEHAVIORRAL HEALTH WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY |
| NOT ELIGIBLE | Other | CT | BEACON HEALTH STRATEGIES |
| 060669107 | Other | CT | UBH-OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | AETNA BEHAVIORAL HEALTH WELLMORE GRP/FACILITY |
| NOT ELIGIBLE | Other | CT | MHN TRICARE NORTH |
| PENDING | Other | CT | CIGNA BEHAVIORAL HEALTH |
| NOT ELIGIBLE | Other | CT | MHN-MANAGED HEALTH NETWORK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Women'S Counseling Center, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1881002368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 OLD NEW MILFORD ROAD",
"address_2": "SUITE 1-B",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "06804",
"telephone_number": "203-775-2583",
"fax_number": "203-775-2863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-574-9000",
"fax_number": "203-574-9006"
}
],
"practiceLocations": [
{
"address_1": "2 Old New Milford Road",
"address_2": "Suite 1-B",
"address_purpose": "LOCATION",
"city": "Brookfield",
"state": "CT",
"postal_code": "06804",
"country_code": "US",
"telephone_number": "203-775-2583",
"fax_number": "203-775-2863",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANDALL",
"first_name": "EMILY",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "2218",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHYCT WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-CONNECTICARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13671806",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BEHAVIORRAL HEALTH WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH STRATEGIES",
"identifier": "NOT ELIGIBLE",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN TRICARE NORTH",
"identifier": "NOT ELIGIBLE",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN-MANAGED HEALTH NETWORK",
"identifier": "NOT ELIGIBLE",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.