Individual provider Active NPI

Chana Selevan, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1043170376
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15841 Issued in CT
Practice address
17 Stephana LN
Waterbury, CT 06710-1127
Phone
(203) 699-6577
NPI assigned
Nov 18, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 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 15841 CT Primary

Addresses

Primary practice location

17 Stephana LN
Waterbury, CT 06710-1127

Mailing address

17 Stephana LN
Waterbury, CT 06710-1127

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
I20260123002224 CT Practitioner - Clinical Social Worker 1951888643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathway Health LLCGroup PAC ID 1456891209, 4 clinicians

Practice addresses (Care Compare)

133 Columbia Blvd
Waterbury, CT 06710-1706
Phone (203) 723-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15841CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Health LLC CurrentSince Nov 18, 2025 Accepting new patients
Align Motion LLC PastSince Nov 18, 2025 Accepting new patients

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": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1043170376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STEPHANA LN",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067101127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STEPHANA LN",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067101127",
            "telephone_number": "203-699-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELEVAN",
        "first_name": "CHANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.