Jacqueline Ivana Stevens, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6921 Issued in CT

Practice address

954 Birmingham St
Bridgeport, CT 06606-3203

Phone

(203) 682-5278

NPI assigned

Feb 6, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Southern Connecticut Christian Counseling CenterGroup PAC ID 9133266109, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindfullyme Mental Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stratford, CT
  • NPI 1306708235
  Medicare reassignment NPD Authorized official
• Southern Connecticut Christian Counseling Center

  • Community/Behavioral Health Agency
  • Fairfield, CT
  • NPI 1164652871
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1033972500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 BIRMINGHAM ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063203",
            "telephone_number": "203-682-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 BIRMINGHAM ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063203",
            "telephone_number": "203-682-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JACQUELINE",
        "middle_name": "IVANA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Stephens, LCSW
• Romalin Stephens, LPN
• Natalie Nicole Stepniak, PA-C
• Thamara Sterling, APRN
• Logan Stern, APRN
• Kimberly Wood Stevens, OD
• Lauren Alyssa Stevens, DPM
• Stewart C Gross MD
• Kendall Morgan Stewart, PT, DPT
• Tjuana Stewart

• Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.