Active NPI
Ivy Erazo, LMSW
- Clinical Social Worker
- Vernon, CT
National Provider Identifier
1073308649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8525
- Practice address
- 306 Merline Rd
Vernon, CT 06066-4030 - Phone
- (860) 716-3667
- NPI assigned
- Apr 14, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8525 | CT | Primary |
Addresses
Primary practice location
306 Merline Rd
Vernon, CT 06066-4030
Mailing address
306 Merline Rd
Vernon, CT 06066-4030
Phone (860) 716-3667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8525 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744588800000",
"number": "1073308649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 MERLINE RD",
"city": "VERNON",
"state": "CT",
"postal_code": "060664030",
"telephone_number": "860-716-3667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 MERLINE RD",
"city": "VERNON",
"state": "CT",
"postal_code": "060664030",
"telephone_number": "860-716-3667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERAZO",
"first_name": "IVY",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-14",
"last_updated": "2025-04-14",
"certification_date": "2025-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "8525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.