Individual provider Active NPI

Christeli Elizabeth Brunner, LCSW

  • Clinical Social Worker
  • Winsted, CT
National Provider Identifier
1972624211
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004895 Issued in CT
Practice address
132 Williams Ave
Winsted, CT 06098-1120
Phone
(860) 379-0918
NPI assigned
Apr 3, 2007
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 004895 CT Primary

Addresses

Primary practice location

132 Williams Ave
Winsted, CT 06098-1120

Mailing address

132 Williams Ave
Winsted, CT 06098-1120
Phone (860) 379-0918

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
I20070730000803 CT Practitioner - Clinical Social Worker 5496856700 Reassigns benefits to 1 organization
Practice locations: Winsted, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

92 High St
Winsted, CT 06098-1527
Phone (860) 806-1056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004895CTMDPhysical Therapist
4895CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince May 25, 2007 Accepting new patients
State of Connecticut CurrentSince May 25, 2007 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

249 Winsted Rd
Fl 3
Torrington, CT 06790
Phone (860) 496-3700

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972624211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 WILLIAMS AVE",
            "city": "WINSTED",
            "state": "CT",
            "postal_code": "060981120",
            "telephone_number": "860-379-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 WILLIAMS AVE",
            "city": "WINSTED",
            "state": "CT",
            "postal_code": "060981120",
            "telephone_number": "860-379-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "CHRISTELI",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winsted, CT

Sources for this page

Verify at the official NPI Registry.