COMMUNITY RENEWAL TEAM (NPI# 1679748628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679748628 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RENEWAL TEAM |
| Practice Address |
675 Tower Ave Mob, Suite 308 Hartford CT 06112-1273 |
| Practice Telephone | 8607149200 |
| Practice Fax Number | 8607148516 |
| Mailing Telephone | 8607149200 |
| Mailing Fax Number | 8607148516 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2013-11-07 |
| Authorized Official Name | MRS. PATRICIA POLLICINA (CLINICIAN) |
| Authorized Official Telephone | 8607149200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
006427 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BILLING PROVIDER NUMBER | 004243747 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881853034 | Community Renewal Team | Social Worker | 949 Pleasant Valley Rd Apt 4-12, South Windsor, CT 06074-4237 | 2008-06-03 |
| 1124397518 | Community Renewal Team | Counselor | 1921 Park St, Hartford, CT 06106-2118 | 2011-12-14 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1629145065 | Community Renewal Team | Marriage & Family Therapist | 11 Mountain Ave, Suite204, Bloomfield, CT 06002-2343 | 2006-11-29 |
| 1669542379 | Community Renewal Team | Community/Behavioral Health | 675 Tower Ave, Hartford, CT 06112-1260 | 2006-11-09 |
| Street Address |
675 TOWER AVE MOB, SUITE 308 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467448878 | Kimberly L Beaulieu | Physician Assistant | 675 Tower Ave, Hartford, CT 06112-1264 | 2005-09-21 |
| 1053833475 | Mona Anne Chiurillo | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2017-07-07 |
| 1457758179 | Shivanna Subramani Gonzalez | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2014-11-24 |
| 1750626032 | Melissa Leigh Costanzo | Marriage & Family Therapist | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2012-11-28 |
| 1477846319 | Susana L Mealha | Social Worker | 675 Tower Ave, Suite 303, Hartford, CT 06112-1273 | 2011-05-25 |
| 1396038691 | Javeeria Manzoor | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-05-18 |
| 1912204504 | Elaine F Pratt | Nurse Practitioner | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-02-17 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1144522160 | Community Renewal Team Inc. | Case Management | 675 Tower Ave, Hartford, CT 06451 | 2010-11-23 |
| 1154638815 | Mahreen Raza | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2010-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367431 | Rise Clinical Services, LLC | Social Worker | 151 New Park Ave Unit 2b, Hartford, CT 06106-2191 | 2020-02-05 |
| 1902441025 | Danielle Gatny | Social Worker | 57418 County Road 681 Ste C, Hartford, MI 49057-9421 | 2019-11-13 |
| 1336781806 | A Minds Journey LLC | Social Worker | 1339 Albany Ave, Hartford, CT 06112-2107 | 2019-10-16 |
| 1689147340 | Comfort Counseling and Wellness | Social Worker | 74 Mansfield St, Hartford, CT 06112-1938 | 2019-01-05 |
| 1275010324 | Oasis Bilingual Counseling Services, LLC. | Social Worker | 682 Prospect Ave # 202, Hartford, CT 06105-4238 | 2018-07-22 |
| 1689196859 | Luisa Dinino-jones | Social Worker | 90 Retreat Ave, Hartford, CT 06106-2535 | 2017-07-10 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1881141356 | Deborah Rogala | Social Worker | 110 Bartholomew Ave Suite 3010, Hartford, CT 06106 | 2016-09-01 |
| 1346796737 | Monica Alvarenga | Social Worker | 27 Carpenter St, Hartford, CT 06106-2008 | 2016-08-26 |
| 1033573860 | Katherine Gebhardt Carbine | Social Worker | 157 Charter Oak Ave, Hartford, CT 06106-1913 | 2016-04-07 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.