NPIMap

Jewish Family Services of Greater Hartford

Organization Active NPI Clinical Social Worker · West Hartford, CT

NPI 1891740221 · NPPES record last updated Dec 21, 2022

Key facts

NPI
1891740221
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
JEWISH FAMILY SERVICES OF GREATER HARTFORD
Practice address
333 Bloomfield Ave
Suite a
West Hartford, CT 06117-1544
Phone
(860) 236-1927
Fax
(860) 236-6483
NPI assigned
May 24, 2006
Organization subpart
No

Authorized official

Name
Ms. Katherine E Hanley, LMSW
Title
Chief Executive Officer
Phone
(860) 761-7087

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050602000098 CT Part B Supplier - Clinic/Group Practice 3072556984 Receives reassigned benefits from 18 practitioners
Practice locations: West Hartford, CT

National Provider Directory

Tax ID family
Jewish Fam Serv of Greater Hartford (2 organizations share this tax ID)

Locations

333 Bloomfield Ave
Ste A
West Hartford, CT 06117
Phone (860) 236-1927

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101Y00000X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X Yes
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X
Child & Adolescent Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0804X
Geriatric Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0805X

Addresses

Primary practice location

333 Bloomfield Ave
Suite a
West Hartford, CT 06117-1544

Mailing address

333 Bloomfield Ave
Suite a
West Hartford, CT 06117-1544
Phone (860) 236-1927

Other identifiers

IdentifierTypeStateIssuer
004083672MedicaidCT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 21, 2022.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1891740221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BLOOMFIELD AVE",
            "address_2": "SUITE A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171544",
            "telephone_number": "860-236-1927",
            "fax_number": "860-236-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BLOOMFIELD AVE",
            "address_2": "SUITE A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171544",
            "telephone_number": "860-236-1927",
            "fax_number": "860-236-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY SERVICES OF GREATER HARTFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "HANLEY",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "860-761-7087",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004083672",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

All providers in West Hartford, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.