Lynn Karen Dove, LCSW
Individual provider Active NPI Clinical Social Worker · Mansfield Center, CT
NPI 1992847305 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992847305
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4648 (CT)
- Practice address
- 12C Ledgebrook Dr
Suite #3
Mansfield Center, CT 06250-1664 - Phone
- (860) 423-3065
- Fax
- (860) 423-3566
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
12 C Ledgebrook Dr
Suite 3
Mansfield Center, CT 06250-1686
Phone (860) 423-3065
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120227000735 | CT | Practitioner - Clinical Social Worker | 4082872775 | Practice locations: Mansfield Center, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004648 | CT | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4648 | CT | Yes |
Addresses
Primary practice location
12C Ledgebrook Dr
Suite #3
Mansfield Center, CT 06250-1664
Mailing address
12C Ledgebrook Dr
Suite #3
Mansfield Center, CT 06250-1664
Phone (860) 423-3065
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140004648CT02 | Other | CT | ANTHEM BEHAVIORAL HEALTH |
| 237488 | Other | CT | MHN |
| 62-25415 | Other | CT | UNITED BEHAVIORAL HEALTH |
Other providers in Mansfield Center, CT
- Irene J. Demers
- Kristin Amanda Dilaj
- Kristine Leslie Dimartino
- Lisa Donahue
- Marcia A Donofrio
- David Duffield
- Stanley Paul Dugan
- Karen V Duhamel
- Katherine Ann Dunn
- Cindy Dupointe
All providers in Mansfield Center, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.