Individual provider Active NPI

Alice R Demeo, LCSW

  • Clinical Social Worker
  • New Milford, CT
National Provider Identifier
1104018910
Registry record updated Sep 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006112 Issued in CT
Practice address
26 Bank St
New Milford, CT 06776-2706
Phone
(203) 241-9470
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2010

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 006112 CT Primary

Addresses

Primary practice location

26 Bank St
New Milford, CT 06776-2706

Mailing address

26 Bank St
New Milford, CT 06776-2706
Phone (203) 241-9470

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

LicenseStateTypeSpecialty
006112CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285459200000",
    "number": "1104018910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BANK ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762706",
            "telephone_number": "203-241-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BANK ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762706",
            "telephone_number": "203-241-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMEO",
        "first_name": "ALICE",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2010-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.