Individual provider Active NPI

Ana Cristina Jardim Messenger, LCSW

  • Clinical Social Worker
  • Southport, CT
National Provider Identifier
1013648393
Registry record updated Jun 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
011782 Issued in CT
Practice address
2960 Post Rd FL 3
Southport, CT 06890-1268
Phone
(203) 307-3030
NPI assigned
Jun 18, 2022
Last updated
Jun 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2022

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 011782 CT Primary

Addresses

Primary practice location

2960 Post Rd FL 3
Southport, CT 06890-1268

Mailing address

30 Hyde LN
Westport, CT 06880-3916
Phone (203) 450-5206

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ana.jardim@coastalconnecticutcounseling.com Direct Coastal Connecticut Counseling LLC

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
I20220829002790 CT Practitioner - Clinical Social Worker 9234513094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Coastal Connecticut Counseling LLCGroup PAC ID 8527361161, 9 clinicians

Practice addresses (Care Compare)

2960 Post Rd
Suite 3B2
Southport, CT 06890-1268
Phone (203) 307-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011782CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Knowing Clarity LLC Clinical Current Accepting new patients
Coastal Connecticut Counseling LLC CurrentSince Jul 25, 2022 Accepting new patients

Locations

1 Eliot Pl
#3C
Fairfield, CT 06824

1 Eliot Pl
Ste 3
Fairfield, CT 06824

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

2960 Post Rd
Ste 3B2
Southport, CT 06890
Phone (203) 307-3030

Interoperability endpoints

  • Direct secure messaging: ana.jardim@coastalconnecticutcounseling.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1013648393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HYDE LN",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803916",
            "telephone_number": "203-450-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 POST RD FL 3",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901268",
            "telephone_number": "203-307-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSENGER",
        "first_name": "ANA",
        "middle_name": "CRISTINA JARDIM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ana.jardim@coastalconnecticutcounseling.com",
            "affiliation": "Y",
            "endpointDescription": "professional email address",
            "affiliationName": "Coastal Connecticut Counseling LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct email",
            "address_1": "2960 Post Rd Fl 3",
            "city": "Southport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068901268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.