Individual provider Active NPI

Taylor Catherine Rispoli, LPC

  • Clinical Social Worker
  • Fairfield, CT
National Provider Identifier
1174004758
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11510 Issued in CT
Practice address
2228 Black Rock Tpke
Fairfield, CT 06825-3256
Phone
(203) 640-1013
Fax
(203) 640-1013
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 11510 CT Primary

Addresses

Primary practice location

2228 Black Rock Tpke
Fairfield, CT 06825-3256

Mailing address

33 Wheeler St
Shelton, CT 06484-2219
Phone (203) 640-1013

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
I20210608003678 CT Practitioner - Clinical Social Worker 0143620492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11510CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince Jun 1, 2021 Accepting new patients
Tailored Wellness LLC Clinical CurrentSince Apr 21, 2024 Accepting new patients

Locations

2228 Black Rock Tpke
Ste 202
Fairfield, CT 06825
Phone (203) 572-5239

2228 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 640-1013

460 Naugatuck Ave
#C
Milford, CT 06460
Phone (203) 915-1719

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

Organizations & group practices 2

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1174004758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WHEELER ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064842219",
            "telephone_number": "203-640-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253256",
            "telephone_number": "203-640-1013",
            "fax_number": "203-640-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISPOLI",
        "first_name": "TAYLOR",
        "middle_name": "CATHERINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.