Jamie Perry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

011212 Issued in CT

Practice address

111 New Haven Ave
Derby, CT 06418-2197

Phone

(475) 439-9639

NPI assigned

May 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Somatic Grove Wellness PLLC

  • Clinical Social Worker
  • Rocky Hill, CT
  • NPI 1366379653
  NPD Authorized official

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1194390617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FARMWOOD DR",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NEW HAVEN AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182197",
            "telephone_number": "475-439-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JAMIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Gebhart Paul, MD
• Andrew John Paulson, MS, ANP-BC
• Mary Mascolo Pellitteri, LADC
• Melissa C. Perkins, LPC
• Hannah Rose Perlroth, APRN
• Peter J. Stein LLC
• Joanna E Peters, CRNA
• Silvena Petrova, PHARMD
• Physical Therapy of Southern Connecticut, P.C.
• Jenna Pires, LCSW

• Clinical Social Worker in Derby, CT
• Providers in Derby, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.