John A Pacheco, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001606 Issued in CT

Practice address

1825 Barnum Ave
Suite #304
Stratford, CT 06614-5333

Phone

(203) 375-5782

Fax

(203) 375-3048

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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, 1984

Medicare assignment

May accept Medicare assignment

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.

• Personal Growth Concepts, Inc.

  • Clinical Social Worker
  • Stratford, CT
  • NPI 1104850353
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1073531133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MAIN ST STE 231",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155839",
            "telephone_number": "203-375-5782",
            "fax_number": "203-375-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 BARNUM AVE",
            "address_2": "SUITE #304",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145333",
            "telephone_number": "203-375-5782",
            "fax_number": "203-375-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000248",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oronoque Pharmacy Inc.
• Orthopaedic Specialty Group
• Hussam Othman, PHARMACIST
• Mark Martin Ovesny
• Sonia Oxendine, LMSW
• David Martin Pagar, DAVID PAGAR, D.D.S.
• Nicole Palanca
• Nicole C Palin, PHARMD
• Cole Papakyrikos, MD
• Linda Papp, LPC

• Clinical Social Worker in Stratford, CT
• Providers in Stratford, 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 Jan 31, 2017; 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.