Individual provider Active NPI

Susana Doolittle, LCSW

  • Clinical Social Worker
  • Willimantic, CT
National Provider Identifier
1942688486
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010606 Issued in CT
Practice address
40 Mansfield Ave
Willimantic, CT 06226-2018
Phone
(860) 450-0585
Fax
(860) 450-0763
NPI assigned
May 18, 2015
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 010606 CT Primary

Addresses

Primary practice location

40 Mansfield Ave
Willimantic, CT 06226-2018

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-0585

Other practice location 1

693 Bloomfield Ave
Bloomfield, CT 06002-2489
Phone (860) 243-6584

Other practice location 2

444 Center St
Manchester, CT 06040-3926
Phone (860) 646-3888

Other names 1

  • Susana Grados Former name

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
I20190625003117 CT Practitioner - Clinical Social Worker 3870827876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Generations Family Health Center IncGroup PAC ID 4880640630, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010606CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince May 13, 2019 Accepting new patients

Locations

693 Bloomfield Ave
Bloomfield, CT 06002
Phone (860) 243-6584

474 School St
#R
East Hartford, CT 06108
Phone (860) 730-8811

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

2 Waterside Xing
Ste 401
Windsor, CT 06095

995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351

Organizations & group practices 1

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1942688486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-0585",
            "fax_number": "860-450-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-0585",
            "fax_number": "860-450-0763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "693 Bloomfield Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "CT",
            "postal_code": "060022489",
            "country_code": "US",
            "telephone_number": "860-243-6584",
            "fax_number": "860-243-6591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "DOOLITTLE",
        "first_name": "SUSANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANA",
            "last_name": "GRADOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.