Debra R Sidewater, R.D.,M.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

555 Willard Ave
Nutrition Clinic, Second Floor
Newington, CT 06111-2631

Phone

(860) 667-6797

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174621064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 VANDERVERE RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172745",
            "telephone_number": "860-232-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "address_2": "NUTRITION CLINIC, SECOND FLOOR",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "860-667-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEWATER",
        "first_name": "DEBRA",
        "middle_name": "R",
        "credential": "R.D.,M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "R464768",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIABETES EDUCAT",
            "identifier": "1027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIETITIAN",
            "identifier": "000128",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zuleyka Morales Shaw, LMFTA
• Shaws Supermarkets Inc
• Karen Shea, PT
• Michael Selden Sherman, PHARM.D.
• Beverly Shoenberger, L.P.C.
• Erin Emonds Silvester, PHARMD
• Erica Simpkins, PT
• Akhilesh Kumar Singh, MD
• John Siraco, M.D.
• Mark Skinner, PT

• Social Worker in Newington, CT
• Providers in Newington, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.