Jessica Anne Collelo-Bibeau, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9144 Issued in CT

Practice address

554 Liberty Hwy Ste 6
Putnam, CT 06260-2728

Phone

(860) 412-4598

NPI assigned

Nov 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Fordham University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Honest Intentions Therapy LLC

  • Clinical Social Worker
  • Putnam, CT
  • NPI 1518663376
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1043789142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541",
            "city": "BROOKLYN",
            "state": "CT",
            "postal_code": "062340541",
            "telephone_number": "860-428-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LIBERTY HWY STE 6",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062602728",
            "telephone_number": "860-412-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLELO-BIBEAU",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "09144",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristiyan S. Chervenkov, MD
• April Chitwood, DPT
• Christopher R Payette
• Margaret A Clark
• Cole Vision Corporation
• Christine Lynn Collins, LPC
• Susan C Collins, APRN
• Coraliz Colon-Ortiz
• Jourhana Colon
• Connecticut CVS Pharmacy, LLC

• Clinical Social Worker in Putnam, CT
• Providers in Putnam, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.