Individual provider Active NPI

Brianna Marks, LCSW

  • Clinical Social Worker
  • Naugatuck, CT
National Provider Identifier
1205505757
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
16 Hillside Ave
Naugatuck, CT 06770-4019
Phone
(203) 528-5854
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 CT Primary

Addresses

Primary practice location

16 Hillside Ave
Naugatuck, CT 06770-4019

Mailing address

659 Chamberlain Hwy
Berlin, CT 06037-1957
Phone (860) 705-2405

Other practice location 1

515 Centerpoint Dr Ste 20
Middletown, CT 06457-7570
Phone (860) 705-2405

Other names 1

  • Brianna Agosta-Lawes Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rethinkbehavioralhealth Collaborative ABA Services LLC

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
I20240830000257 CT Practitioner - Clinical Social Worker 1153860424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Neuropsychology LLCGroup PAC ID 3375602931, 16 clinicians

Practice addresses (Care Compare)

609 W Johnson Ave
Suite 104
Cheshire, CT 06410-4506
Phone (203) 272-6007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stokes Counseling Services LLC Clinical CurrentSince Jul 9, 2024 Accepting new patients
Northeast Neuropsychology, LLC CurrentSince Dec 2, 2024 Accepting new patients
Chapter One Counseling LLC Clinical CurrentSince Jul 21, 2024 Accepting new patients
Advanced Telepsych PLLC PastSince Jan 1, 2024 Accepting new patients

Locations

609 W Johnson Ave
Ste 104
Cheshire, CT 06410
Phone (203) 272-6007

16 Hillside Ave
Naugatuck, CT 06770
Phone (203) 729-0341

Organizations & group practices 4

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1205505757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 CHAMBERLAIN HWY",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371957",
            "telephone_number": "860-705-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HILLSIDE AVE",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704019",
            "telephone_number": "203-528-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Centerpoint Dr Ste 20",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064577570",
            "country_code": "US",
            "telephone_number": "860-705-2405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "BRIANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rethinkbehavioralhealth",
            "affiliation": "Y",
            "endpointDescription": "electronic treatment record",
            "affiliationName": "Collaborative ABA Services LLC",
            "address_1": "515 Centerpoint Dr Ste 20",
            "city": "Middletown",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064577570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "AGOSTA-LAWES",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naugatuck, CT

Sources for this page

Verify at the official NPI Registry.