Jennifer Staehly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5480 Issued in CT

Practice address

276 S Main St
Colchester, CT 06415-2952

Phone

(860) 575-9891

NPI assigned

Jan 2, 2015

Last updated

Jan 30, 2019By 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

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

Specialty

Clinical Social Worker

Education

University of Connecticut School of Medicine, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.staehly@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jennifer B Staehly LCSW LLC

  • Community/Behavioral Health Agency
  • Colchester, CT
  • NPI 1710453220
  Medicare reassignment NPD Authorized official
• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1467482539
  Medicare reassignment NPD
• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1558366757
  NPD

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1215325097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 TOWN ST",
            "city": "EAST HADDAM",
            "state": "CT",
            "postal_code": "064231425",
            "telephone_number": "860-575-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 S MAIN ST",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152952",
            "telephone_number": "860-575-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Town St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602323",
            "country_code": "US",
            "telephone_number": "860-892-7042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAEHLY",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "5480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Smith, NTP, RWP
• Kimberly Smith, PHARM.D.
• Tanya Doreen Smith, CNM
• Peter J Sposato, R.PH., BCNP
• Nicole Lauree St Cyr, D.C.
• Rebecca Stamatiou, DC
• Carol Ann Starzyk, OTR
• Kirsti Joberg Stennett, PT
• Christine Stewart, OTR/L
• Suburban Home Medical, Inc

• Clinical Social Worker in Colchester, CT
• Providers in Colchester, 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 Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.