Active NPI
Michele Granville Watson, LCSW
- Clinical Social Worker
- Hartford, CT
National Provider Identifier
1902388234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 012160
- Practice address
- 330 Market St
Hartford, CT 06120-2901 - Phone
- (860) 761-7908
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 012160 | CT | Primary |
| Social Worker | 104100000X | 4845 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
330 Market St
Hartford, CT 06120-2901
Mailing address
106 Barry Rd
Manchester, CT 06042-3326
Phone (860) 287-0384
Other practice location 1
444 Center St
Manchester, CT 06040-3926
Phone (860) 646-3888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4845 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673481600000",
"number": "1902388234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 BARRY RD",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060423326",
"telephone_number": "860-287-0384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MARKET ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061202901",
"telephone_number": "860-761-7908"
}
],
"practiceLocations": [
{
"address_1": "444 Center St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "CT",
"postal_code": "060403926",
"country_code": "US",
"telephone_number": "860-646-3888",
"fax_number": "860-645-4132",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATSON",
"first_name": "MICHELE",
"middle_name": "GRANVILLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2023-01-12",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "012160",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "4845",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.