Individual provider Active NPI

Eric Brysgel, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1912950213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004734 Issued in CT
Practice address
401 West Thames Street
Southeastern Mental Health Authority
Norwich, CT 06360
Phone
(860) 859-4674
Fax
(860) 859-4790
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 004734 CT Primary

Addresses

Primary practice location

401 West Thames Street
Southeastern Mental Health Authority
Norwich, CT 06360

Mailing address

401 West Thames Street
BLDG 301
Norwich, CT 06360
Phone (860) 859-4674

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
I20050826000509 CT Practitioner - Clinical Social Worker 6709817943 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians
Within Reach LLCGroup PAC ID 3678804879, 5 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

225 N Main St
Bristol, CT 06010-4926
Phone (203) 510-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince May 24, 2016 Accepting new patients
State of Connecticut CurrentSince May 24, 2016 Accepting new patients
Harvest Healthcare LLC Clinical CurrentSince May 15, 2023 Accepting new patients
Within Reach LLC Clinical CurrentSince Oct 13, 2020 Accepting new patients
State of Connecticut PastSince Jan 1, 2002 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

225 N Main St
Bristol, CT 06010
Phone (203) 510-1002

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

Organizations & group practices 5

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912950213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSGEL",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.