Andrea Servan, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

5198 Issued in CT

Practice address

255 Dayton Rd
Bridgeport, CT 06606-3116

Phone

(203) 998-8679

NPI assigned

Apr 9, 2020

Last updated

Mar 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1063031144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 DAYTON RD",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063116",
            "telephone_number": "203-998-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 DAYTON RD",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063116",
            "telephone_number": "203-998-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVAN",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "118320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.012571",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CT",
            "license": "4204268615",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "5198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Heriberto Sepulveda, D.C., M.S.
• Serene Harbor Psychiatry PLLC
• Joseph A. Seres IV
• Amanda Leigh Serino, P.A.
• Carmen Serrano
• Gregory T Servetas, MD
• Samdish Sethi
• Ronald J Setkoski II, PA-C
• Corinne R Seville, PSYD
• Kiran Shabbir, LPC

• 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 Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.