Individual provider Active NPI

Amy M Lakin, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1932554417
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009411 Issued in CT
Practice address
28 Crescent St
Emps
Middletown, CT 06457-3654
Phone
(203) 907-6301
NPI assigned
May 3, 2016
Last updated
May 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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 009411 CT Primary

Addresses

Primary practice location

28 Crescent St
Emps
Middletown, CT 06457-3654

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (203) 907-6301

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
I20191028000146 CT Practitioner - Clinical Social Worker 3971835810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009411CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Twelve Solutions, Inc. CurrentSince Jun 10, 2024 Accepting new patients
Southeastern Pulmonary Assoc. PC PastSince Jun 10, 2024 Accepting new patients

Locations

155 Montauk Ave
New London, CT 06320
Phone (860) 444-2223

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1932554417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "203-907-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "address_2": "EMPS",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "203-907-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKIN",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.