Active NPI
Keith McPherson, LMSW
- Social Worker
- Bridgeport, CT
National Provider Identifier
1033076419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11669
- Practice address
- 655 Park Ave
Bridgeport, CT 06604-4611 - Phone
- (203) 338-0669
- NPI assigned
- Jan 7, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11669 | CT | Primary |
Addresses
Primary practice location
655 Park Ave
Bridgeport, CT 06604-4611
Mailing address
1711 Townsend Ave Apt 3F
Bronx, NY 10453-7972
Phone (646) 460-1639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11669 | CT | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Behavioral Rehabilitation Institute Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Bridgeport, CT
- NPI 1467916197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767744000000",
"number": "1033076419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 TOWNSEND AVE APT 3F",
"city": "BRONX",
"state": "NY",
"postal_code": "104537972",
"telephone_number": "646-460-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 PARK AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066044611",
"telephone_number": "203-338-0669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCPHERSON",
"first_name": "KEITH",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-07",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "11669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.