Individual provider Active NPI

Elijah M Legassie

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1891501359
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1310 Main St
Willimantic, CT 06226-1910
Phone
(860) 731-5522
Fax
(860) 731-5536
NPI assigned
Dec 9, 2024
Last updated
May 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8339 CT
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1310 Main St
Willimantic, CT 06226-1910

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 697-3351

Other practice location 1

71 Westcott Rd
Danielson, CT 06239-2929
Phone (860) 731-5522

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
I20250602000734 CT Practitioner - Clinical Social Worker 8426567561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Resources, Inc.Group PAC ID 5597652149, 50 clinicians

Practice addresses (Care Compare)

1310 Main St
Willimantic, CT 06226-1910
Phone (860) 456-0038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8339CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince May 23, 2025 Accepting new patients
Community Health Resources, Inc CurrentSince May 23, 2025 Accepting new patients

Locations

71 Westcott Rd
Danielson, CT 06239
Phone (860) 774-7179

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

1310 Main St
Willimantic, CT 06226
Phone (860) 456-0038

2 Waterside Xing
Ste 401
Windsor, CT 06095

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1891501359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-697-3351",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261910",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Westcott Rd",
            "address_purpose": "LOCATION",
            "city": "Danielson",
            "state": "CT",
            "postal_code": "062392929",
            "country_code": "US",
            "telephone_number": "860-731-5522",
            "fax_number": "890-731-5536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGASSIE",
        "first_name": "ELIJAH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "8339",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.