Individual provider Active NPI

Heather K Mazarakos, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Stamford, CT
National Provider Identifier
1083989628
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
007902 Issued in CT
Practice address
141 Franklin St
Stamford, CT 06901-1014
Phone
(203) 602-4441
Fax
(203) 602-7782
NPI assigned
Mar 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 007902 CT Primary
Mental Health Counselor 101YM0800X 007902 CT

Addresses

Primary practice location

141 Franklin St
Stamford, CT 06901-1014

Mailing address

350 Fairfield Ave
Suite 701
Bridgeport, CT 06604-6014
Phone (203) 335-5225

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
I20130730000820 CT Practitioner - Clinical Social Worker 2668613803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

161 Cook Hill Rd
Wallingford, CT 06492-3408
Phone (203) 253-9708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007902CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Institute for Communities Inc CurrentSince Sep 1, 2020 Accepting new patients
Connecticut Institute for Communities Inc CurrentSince Sep 1, 2020 Accepting new patients
Apex Community Care, Inc CurrentSince Mar 1, 2024 Accepting new patients
Oss Sports Physical Therapy PLLC PastSince Aug 2, 2020 Accepting new patients

Locations

30 West St
Danbury, CT 06810
Phone (203) 778-2437

57 North St
Ste 103
Danbury, CT 06810
Phone (203) 744-7007

16 Hospital Ave
Danbury, CT 06810
Phone (203) 730-2900

85 West St
Danbury, CT 06810
Phone (203) 778-2437

120 Main St
Danbury, CT 06810
Phone (203) 456-1406

Organizations & group practices 4

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1083989628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FAIRFIELD AVE",
            "address_2": "SUITE 701",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066046014",
            "telephone_number": "203-335-5225",
            "fax_number": "203-336-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 FRANKLIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069011014",
            "telephone_number": "203-602-4441",
            "fax_number": "203-602-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZARAKOS",
        "first_name": "HEATHER",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "007902",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "007902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.