Individual provider Active NPI

Kristine Johnson Rbo, LCSW, LADC

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1972617900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000199 Issued in CT
Practice address
303 Whitney Ave
New Haven, CT 06511-7204
Phone
(203) 464-0592
Fax
(203) 407-1892
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 000199 CT Primary

Addresses

Primary practice location

303 Whitney Ave
New Haven, CT 06511-7204

Mailing address

44 Marion Rd
Bethany, CT 06524-3007
Phone (203) 464-0592

Other identifiers 2

IdentifierTypeStateIssuer
000199OtherCTLICENSE/LCSW
000007OtherCTLICENSE/LADC

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
I20040820000737 CT Practitioner - Clinical Social Worker 8820062490 Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 Whitney Ave
New Haven, CT 06511-7204
Phone (203) 464-0592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000199CTMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972617900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MARION RD",
            "city": "BETHANY",
            "state": "CT",
            "postal_code": "065243007",
            "telephone_number": "203-464-0592",
            "fax_number": "203-407-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065117204",
            "telephone_number": "203-464-0592",
            "fax_number": "203-407-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RBO",
        "first_name": "KRISTINE",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE/LCSW",
            "identifier": "000199",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE/LADC",
            "identifier": "000007",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.