Individual provider Active NPI

Jannette Stern, JANNETTE STERN, LCSW

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1225105216
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005991 Issued in CT
Practice address
2001 W Main St
Suite 106B
Stamford, CT 06902-4501
Phone
(203) 353-8446
Fax
(203) 353-8446
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005991 CT Primary

Addresses

Primary practice location

2001 W Main St
Suite 106B
Stamford, CT 06902-4501

Mailing address

2001 W Main St
Suite 106B
Stamford, CT 06902-4501
Phone (203) 353-8446

Other identifiers 5

IdentifierTypeStateIssuer
P3634405OtherCTOXFORD HEALTH PLANS
7062814OtherCTAETNA INSURANCE
326457OtherCTMHN INSURANCE
11510066OtherCTCAQH PROVIDER ID
140005991CT01OtherCTANTHEM BC BS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
005991CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225105216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W MAIN ST",
            "address_2": "SUITE 106B",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024501",
            "telephone_number": "203-353-8446",
            "fax_number": "203-353-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W MAIN ST",
            "address_2": "SUITE 106B",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024501",
            "telephone_number": "203-353-8446",
            "fax_number": "203-353-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JANNETTE",
        "credential": "JANNETTE STERN, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P3634405",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "7062814",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN INSURANCE",
            "identifier": "326457",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11510066",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "140005991CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.