Active NPI
Dawn Roy, LCSW
- Clinical Social Worker
- Fairfield, CT
National Provider Identifier
1093829871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004279
- Practice address
- 540 Tunxis Hill Rd
1St Floor
Fairfield, CT 06825-4412 - Phone
- (203) 331-7458
- NPI assigned
- Aug 18, 2006
- 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 | 004279 | CT | Primary |
Addresses
Primary practice location
540 Tunxis Hill Rd
1St Floor
Fairfield, CT 06825-4412
Mailing address
540 Tunxis Hill Rd
1St Floor
Fairfield, CT 06825-4412
Phone (203) 331-7458
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004039244 | Medicaid | CT | |
| 140004279CT01 | Other | CT | ANTHEM BCBS |
| 191105 | Other | CT | MANAGED HEALTH NETWORK |
Other names 1
- Dawn Sutton
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004279 | CT | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridges Healthcare Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/bridgesct/r4/
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 and National Provider Directory roles.
-
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- Milford, CT
- NPI 1851350300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1093829871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 TUNXIS HILL RD",
"address_2": "1ST FLOOR",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068254412",
"telephone_number": "203-331-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 TUNXIS HILL RD",
"address_2": "1ST FLOOR",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068254412",
"telephone_number": "203-331-7458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "DAWN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "004279",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004039244",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "140004279CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "191105",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DAWN",
"last_name": "SUTTON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.