Rose Ellen Persico, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005807 Issued in CT

Practice address

351 Silver St
Middletown, CT 06457-3919

Phone

(860) 262-5220

Fax

(860) 262-5367

NPI assigned

Nov 15, 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Middletown, CT
  • NPI 1427074426
  Medicare reassignment
• Community Renewal Team, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hartford, CT
  • NPI 1841301876
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1942372701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALL ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574705",
            "telephone_number": "860-704-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SILVER ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573919",
            "telephone_number": "860-262-5220",
            "fax_number": "860-262-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSICO",
        "first_name": "ROSE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander John Perfetto
• Joan Perkins, LCSW
• Stephen Perlmutter, D.P.M.
• Amanda Paige Perra
• Kerry Alyssa Perry
• Carol Ann Peters
• Gregory N. Peterson, MD
• Wendy Levin Peterson, APRN
• Margaret M Petersson, PHD LCSW
• Michael Petit, DPT

• Clinical Social Worker in Middletown, CT
• Providers in Middletown, 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 Oct 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.