Active NPI
Mindy Kubrin, LCSW
- Clinical Social Worker
- New Canaan, CT
National Provider Identifier
1205621240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4403
- Practice address
- 71 Elm St Ste 3
New Canaan, CT 06840-5429 - Phone
- (203) 360-2638
- NPI assigned
- Apr 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4403 | CT | Primary |
Addresses
Primary practice location
71 Elm St Ste 3
New Canaan, CT 06840-5429
Mailing address
87 Fulling Mill LN
Ridgefield, CT 06877-3406
Phone (203) 360-2638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4403 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1205621240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 FULLING MILL LN",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068773406",
"telephone_number": "203-360-2638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 ELM ST STE 3",
"city": "NEW CANAAN",
"state": "CT",
"postal_code": "068405429",
"telephone_number": "203-360-2638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBRIN",
"first_name": "MINDY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-10",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "4403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Canaan, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.