Channe Fodeman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001072 Issued in CT

Practice address

12 Hillspoint Road
Westport, CT 06880-4536

Phone

(203) 226-3411

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922114016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HILLSPOINT ROAD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804536",
            "telephone_number": "203-226-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HILLSPOINT ROAD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804536",
            "telephone_number": "203-226-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODEMAN",
        "first_name": "CHANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Fiorentino Jr., N.D.
• Mark Fisher, M.D.
• Fit Home Care LLC
• Jessica K Flanagan, D.O.
• Flora Levin MD LLC
• Leslie J Fodeman, M.D.
• Foenix Medical Consulting PLLC
• Lauren Price Fogarty, PA
• Sarah Fogel, LCSW
• Amy Forte, M.A. RN

• Clinical Social Worker in Westport, CT
• Providers in Westport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.