Individual provider Active NPI

Jennifer L Thompson

  • Clinical Social Worker
  • Newtown, CT
National Provider Identifier
1073692950
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004763 Issued in CT
Practice address
12 Queen St
Newtown, CT 06470-2158
Phone
(203) 232-7711
Fax
(833) 596-1603
NPI assigned
Nov 3, 2006
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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 004763 CT Primary

Addresses

Primary practice location

12 Queen St
Newtown, CT 06470-2158

Mailing address

12 Queen St
Ste 3
Newtown, CT 06470-2173
Phone (203) 232-7711

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
I20141120001882 CT Practitioner - Clinical Social Worker 3779766829 Practice locations: Newtown, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12 Queen St
Newtown, CT 06470-2158
Phone (203) 232-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4763CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cheryl Schwartz, LCSW, LLC Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1073692950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 QUEEN ST",
            "address_2": "STE 3",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702173",
            "telephone_number": "203-232-7711",
            "fax_number": "203-263-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 QUEEN ST",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702158",
            "telephone_number": "203-232-7711",
            "fax_number": "833-596-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, CT

Sources for this page

Verify at the official NPI Registry.