Individual provider Active NPI

Jennifer Giordano, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1003995986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005310 Issued in CT
Practice address
55 West Main Street
Western Connecticut Mental Health Network Suite 410
Waterbury, CT 06702
Phone
(203) 805-6408
Fax
(203) 805-6432
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005310 CT Primary

Addresses

Primary practice location

55 West Main Street
Western Connecticut Mental Health Network Suite 410
Waterbury, CT 06702

Mailing address

55 West Main Street
Western Connecticut Mental Health Network Suite 410
Waterbury, CT 06702
Phone (203) 805-6408

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
I20041221000086 CT Practitioner - Clinical Social Worker 8325006570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005310CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Dec 22, 2016 Accepting new patients
State of Connecticut CurrentSince Dec 22, 2016 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

95 Thomaston Ave
Waterbury, CT 06702
Phone (203) 805-5300

Organizations & group practices 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003995986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "WESTERN CONNECTICUT MENTAL HEALTH NETWORK SUITE 410",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6408",
            "fax_number": "203-805-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "WESTERN CONNECTICUT MENTAL HEALTH NETWORK SUITE 410",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6408",
            "fax_number": "203-805-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIORDANO",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.