PORTIA PENDLETON (NPI# 1104374230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104374230 |
| Entity Type | Individual |
| Full Name | PORTIA PENDLETON |
| Other Name | PORTIA KIMBIS |
| Credential | LMSW |
| Practice Address |
190 Westbrook Rd Essex CT 06426-1518 |
| Mailing Address |
255 Hempstead St New London CT 06320-6204 |
| Practice Telephone | 8607670147 |
| Practice Fax Number | 8607670148 |
| Mailing Telephone | 8604432896 |
| Mailing Fax Number | 8604425909 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2018-11-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LMSW4442 | CT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 255 Hempstead St, New London, CT 063206204 | 8604432896 | 8604425909 |
| Street Address |
190 WESTBROOK RD |
| City | ESSEX |
| State | CT |
| Zip Code | 06426-1518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487647103 | Peter Edward Pool | Dentist | 190 Westbrook Rd, Essex, CT 06426-1518 | 2005-08-28 |
| 1639701667 | Nicole Blanchet | Counselor | 190 Westbrook Rd, Essex, CT 06426-1518 | 2020-02-07 |
| 1073144101 | Lindsey Patricia Massicotte | Social Worker | 190 Westbrook Rd, Essex, CT 06426-1518 | 2020-01-28 |
| 1033767025 | Vincenzo Marafito | Social Worker | 190 Westbrook Rd, Essex, CT 06426-1518 | 2019-09-03 |
| 1316502586 | Erin Vincent | Social Worker | 190 Westbrook Rd, Essex, CT 06426-1518 | 2019-05-03 |
| 1750844635 | Ebony Graham | Counselor | 190 Westbrook Rd, Essex, CT 06426-1518 | 2019-04-09 |
| 1083182778 | Alyssa Ackerson | Social Worker | 190 Westbrook Rd, Essex, CT 06426-1518 | 2018-11-12 |
| 1962977652 | Theresa M Ramponi | Nurse Practitioner | 190 Westbrook Rd, Essex, CT 06426-1518 | 2018-10-09 |
| 1689185761 | Katrina Coyle | Marriage & Family Therapist | 190 Westbrook Rd, Essex, CT 06426-1518 | 2017-10-17 |
| 1558892943 | Caitlin Nuhn | Counselor | 190 Westbrook Rd, Essex, CT 06426-1518 | 2017-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123867 | Art Therapy & Creative Counseling | Counselor | 80 Plains Rd Unit 1, Essex, CT 06426 | 2017-06-05 |
| 1487085593 | Catherine Mary Demers | Nurse Practitioner | 10 Wildwood Medical Center, Essex, CT 06426 | 2013-11-29 |
| 1346515723 | Anne Peterson | Counselor | 80 Plains Rd, Essex, CT 06426 | 2012-03-19 |
| 1477851731 | Diana Leigh Amara | Counselor | 80 Plains Road, Essex, CT 06426 | 2011-03-09 |
| 1609034438 | Marybeth Pytlik Ellison | Pediatrics | Sunflower Developmental Pediatrics, 11 Wildwood Medical Center, Essex, CT 06426 | 2008-05-29 |
| 1780749747 | Dana Lyn Martin | Counselor | 190 Westbrook Road, Essex Child Guidance Clinic, Essex, CT 06426 | 2006-12-27 |
| 1881768836 | Jason Christopher Andrade | Counselor | 190 Westbrock Rd, Essex, CT 06426 | 2006-11-20 |
| 1386735546 | Robert D Dwyer | Urology | 6 Wildwood Medical Center, Essex, CT 06426 | 2006-09-27 |
| 1154421071 | Sharon D Mallon | Psychologist | 251 Westbrook Rd, Essex, CT 06426 | 2006-09-22 |
| 1043319510 | Brian David Fay | Social Worker | 251 Westbrook Road, Essex, CT 06426 | 2006-09-21 |
| Find all providers in zip 06426 | ||||
| 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 |
|---|---|---|---|---|
| 1629579487 | Deirdre Gardner | Social Worker | 768 Seawall Rd, Essex, MD 21221-3939 | 2018-02-26 |
| 1720595242 | Tidemark Intervention Services | Social Worker | 13 Ryan Frost Way, Essex, MD 21221-1646 | 2018-01-05 |
| 1023496106 | Joan Marie Horwat | Social Worker | 28 Cove Hill Rd, Essex, CT 06426-1439 | 2015-05-11 |
| 1568893485 | Eric Kebela | Social Worker | 928 Ashbridge Dr Apt L, Essex, MD 21221-4328 | 2013-12-02 |
| 1922433564 | Joellen Marie Falk | Social Worker | 29 Choate St, Essex, MA 01929-1057 | 2013-09-12 |
| 1740591320 | Michelle A Kenefick | Social Worker | 158 Westbrook Rd, Suite 7, Essex, CT 06426-1553 | 2010-06-29 |
| 1346424710 | Elizabeth Marshall | Social Worker | 1 Wildwood Medical Ctr, Essex, CT 06426-1155 | 2007-12-20 |
| 1225221500 | Karan D Killoran | Social Worker | 24 Stanford Hill Rd, Essex, CT 06426-1431 | 2007-08-21 |
| 1457578809 | Nancy Christine Ann Lucas | Social Worker | 2 Wildwood Medical Ctr, Essex, CT 06426-1154 | 2007-04-19 |
| 1487728846 | Donna E. Lemay | Social Worker | Po Box 8351, Essex, VT 05451-8351 | 2006-11-20 |
| Find all providers in ESSEX | ||||
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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.