Individual provider Active NPI

Dana Segall

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1982149480
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3373 Issued in CT
Practice address
1921 Park St
Hartford, CT 06106-2118
Phone
(860) 951-9022
Fax
(860) 233-2796
NPI assigned
Dec 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 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 3373 CT Primary

Addresses

Primary practice location

1921 Park St
Hartford, CT 06106-2118

Mailing address

1921 Park St
Hartford, CT 06106-2118
Phone (860) 951-9022

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
I20210630003836 CT Practitioner - Clinical Social Worker 1355742156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

191 Albany Tpke
Suite 3
Canton, CT 06019-2571
Phone (203) 819-0789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011109CTMDSocial Worker
3373CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Jan 1, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

191 Albany Tpke
Ste 3
Canton, CT 06019

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

Interoperability endpoints

  • Direct secure messaging: dana.segall.1@28623.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1982149480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-9022",
            "fax_number": "860-233-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-9022",
            "fax_number": "860-233-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALL",
        "first_name": "DANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "3373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.