Individual provider Active NPI

Barbara Despres, LCSW ACSW

  • Clinical Social Worker
  • Wilton, CT
National Provider Identifier
1104972769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000849 Issued in CT
Practice address
89 Blue Ridge Rd
Wilton, CT 06897-2228
Phone
(203) 834-0187
Fax
(203) 761-9028
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000849 CT Primary
Clinical Social Worker 1041C0700X PR016414 NY

Addresses

Primary practice location

89 Blue Ridge Rd
Wilton, CT 06897-2228

Mailing address

89 Blue Ridge Rd
Wilton, CT 06897-2228
Phone (203) 834-0187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2014 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR016414NYMDClinical Social Worker
849CTMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104972769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 BLUE RIDGE RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068972228",
            "telephone_number": "203-834-0187",
            "fax_number": "203-761-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 BLUE RIDGE RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068972228",
            "telephone_number": "203-834-0187",
            "fax_number": "203-761-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPRES",
        "first_name": "BARBARA",
        "credential": "LCSW ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000849",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR016414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton, CT

Sources for this page

Verify at the official NPI Registry.