Individual provider Active NPI

Roxann Marie Ellis-Denby, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1992958094
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006749 Issued in CT
Practice address
51 Coventry Street
Capitol Region Mental Health Center
Hartford, CT 06112
Phone
(860) 297-0922
Fax
(860) 297-0914
NPI assigned
Nov 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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 006749 CT Primary

Addresses

Primary practice location

51 Coventry Street
Capitol Region Mental Health Center
Hartford, CT 06112

Mailing address

500 Vine Street
Human Resource
Hartford, CT 06114
Phone (860) 297-0905

Other names 1

  • Roxann Marie Ellis Former name

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
I20090406000189 CT Practitioner - Clinical Social Worker 6901953140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

500 Vine St
Hartford, CT 06112-1639
Phone (860) 297-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006749CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Minds Journey LLC Clinical CurrentSince May 25, 2020 Accepting new patients
State of Connecticut CurrentSince Sep 12, 2008 Accepting new patients
State of Connecticut CurrentSince Sep 12, 2008 Accepting new patients

Locations

1339 Albany Ave
Hartford, CT 06112
Phone (860) 263-8021

500 Vine St
Hartford, CT 06112
Phone (860) 293-6400

1339 Albany Ave
Ste 1
Hartford, CT 06112

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

51 Coventry St
Hartford, CT 06112
Phone (860) 297-0800

1339 Albany Ave
Fl 1
Hartford, CT 06112
Phone (860) 263-8021

Organizations & group practices 3

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1992958094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VINE STREET",
            "address_2": "HUMAN RESOURCE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06114",
            "telephone_number": "860-297-0905",
            "fax_number": "860-297-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 COVENTRY STREET",
            "address_2": "CAPITOL REGION MENTAL HEALTH CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-297-0922",
            "fax_number": "860-297-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-DENBY",
        "first_name": "ROXANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANN",
            "last_name": "ELLIS",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.