Sara Marie Cosseboom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15541 Issued in CT

Practice address

390 Middlebury Rd Ste 2
Middlebury, CT 06762-2634

Phone

(203) 558-1143

NPI assigned

Aug 1, 2025

Last updated

Aug 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1194609313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HAZEL DR UNIT 117",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101071",
            "telephone_number": "774-608-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MIDDLEBURY RD STE 2",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622634",
            "telephone_number": "203-558-1143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Pomperaug Office Park Ste 103",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064882295",
            "country_code": "US",
            "telephone_number": "203-558-1143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Pomperaug Office Park Ste 206",
            "address_purpose": "LOCATION",
            "city": "Southbury",
            "state": "CT",
            "postal_code": "064882291",
            "country_code": "US",
            "telephone_number": "203-558-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSSEBOOM",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Middlebury, CT
• Providers in Middlebury, 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 Aug 1, 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.