Bold Counsel

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006710 Issued in CT

Legal business name

BOLD COUNSEL

Practice address

27 Visconti Ave
Waterbury, CT 06704-3833

Phone

(203) 707-0039

NPI assigned

Nov 14, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jennifer Michele Sinclair, LCSWNPI 1003142993

Title

Licensed Clinical Social Worker

Phone

(203) 232-8596

Specialties & licenses 1

Addresses

Other names 1

• Bravely Obsessed with Living Daily Counsel Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Michele Sinclair, L.C.S.W.

  • Clinical Social Worker
  • Waterbury, CT
  • NPI 1003142993

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1003329947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 VISCONTI AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067043833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 VISCONTI AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067043833",
            "telephone_number": "203-707-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLD COUNSEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "203-232-8596",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravely Obsessed with Living Daily Counsel",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sondra Iacullo Bogursky, MD
• Barbara Boissonneau
• Samantha Boisvert, LCSW
• Sophia Bolanos
• Maria Bolastig, M.D.,
• Juliana Boldt
• Amanda Bolduc
• Kara Boles
• Rachel Leah Bolinsky
• Anthony Oliver Bonacorsi, D,D,S,

• All providers in Waterbury, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.