Individual provider Active NPI

Evan P Kosilla

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1992405948
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15926 Issued in CT
Practice address
17 S Highland St
West Hartford, CT 06119-1826
Phone
(860) 258-4171
NPI assigned
Mar 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 15926 CT Primary

Addresses

Primary practice location

17 S Highland St
West Hartford, CT 06119-1826

Mailing address

17 S Highland St
West Hartford, CT 06119-1826
Phone (860) 258-4171

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
I20251121002768 CT Practitioner - Clinical Social Worker 0840782405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reflections LLCGroup PAC ID 0941669139, 12 clinicians

Practice addresses (Care Compare)

17 S Highland St
West Hartford, CT 06119-1826
Phone (860) 258-4171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15926CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reflections LLC Mental Health CurrentSince Oct 28, 2025 Accepting new patients

Locations

17 S Highland St
West Hartford, CT 06119
Phone (860) 236-6009

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1992405948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSILLA",
        "first_name": "EVAN",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-08",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.