Individual provider Active NPI

Marissa McKelvie, LCSW

  • Clinical Social Worker
  • Naugatuck, CT
National Provider Identifier
1033922208
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58.014778 Issued in CT
Practice address
16 Hillside Ave
Naugatuck, CT 06770-4019
Phone
(203) 729-0341
Fax
(203) 723-0702
NPI assigned
Jan 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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 58.014778 CT Primary

Addresses

Primary practice location

16 Hillside Ave
Naugatuck, CT 06770-4019

Mailing address

212 Hough Ave
Bridgeport, CT 06608-2819
Phone (203) 556-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58.014778CTMDClinical Social Worker
14778CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stokes Counseling Services LLC Clinical CurrentSince Feb 10, 2025 Accepting new patients

Locations

16 Hillside Ave
Naugatuck, CT 06770
Phone (203) 729-0341

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.

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1033922208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HOUGH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082819",
            "telephone_number": "203-556-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HILLSIDE AVE",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704019",
            "telephone_number": "203-729-0341",
            "fax_number": "203-723-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELVIE",
        "first_name": "MARISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.014778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

Verify at the official NPI Registry.