Individual provider Active NPI

Jennifer M Iannuzzi, MSW, LCSW

  • Clinical Social Worker
  • Ridgefield, CT
National Provider Identifier
1053921007
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009955 Issued in CT
Practice address
38A Grove St Ste 101
Ridgefield, CT 06877-4664
Phone
(203) 896-8888
Fax
(203) 403-9550
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 009955 CT Primary

Addresses

Primary practice location

38A Grove St Ste 101
Ridgefield, CT 06877-4664

Mailing address

49 Granite Dr
Wilton, CT 06897-1318

Other practice location 1

49 Locust Ave
New Canaan, CT 06840-4764
Phone (917) 968-9213

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
I20240726003936 CT Practitioner - Clinical Social Worker 3870039753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emh Family Services PCGroup PAC ID 9931561982, 27 clinicians

Practice addresses (Care Compare)

38 A Grove St
Suite 101
Ridgefield, CT 06877-4664
Phone (203) 689-8989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009955CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Emh Family Services PC CurrentSince Jun 19, 2024 Accepting new patients

Locations

55 Walls Dr
Ste 206
Fairfield, CT 06824
Phone (203) 635-5776

38A Grove St
Ste 101
Ridgefield, CT 06877
Phone (203) 896-8888

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1053921007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 GRANITE DR",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068971318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38A GROVE ST STE 101",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774664",
            "telephone_number": "203-896-8888",
            "fax_number": "203-403-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Locust Ave",
            "address_purpose": "LOCATION",
            "city": "New Canaan",
            "state": "CT",
            "postal_code": "068404764",
            "country_code": "US",
            "telephone_number": "917-968-9213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANNUZZI",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

Verify at the official NPI Registry.