Individual provider Active NPI

Rebecca G Calabrese, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1225138233
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002791 Issued in CT
Practice address
51 Lakeside Boulevard East
Waterbury, CT 06708
Phone
(203) 753-9743
Fax
(203) 286-1293
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

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 002791 CT Primary

Addresses

Primary practice location

51 Lakeside Boulevard East
Waterbury, CT 06708

Mailing address

51 Lakeside Boulevard East
Waterbury, CT 06708
Phone (203) 753-9743

Other identifiers 2

IdentifierTypeStateIssuer
079522OtherCTMHN
140002791CT01OtherCTANTHEM BCBS OF CT

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
I20100929001573 CT Practitioner - Clinical Social Worker 5496871105 Practice locations: Waterbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

51 Lakeside Blvd E
Waterbury, CT 06708-2958

51 Lakeside E Blvd
Waterbury, CT 06708-2958
Phone (203) 753-9743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002791CTMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225138233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 LAKESIDE BOULEVARD EAST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-753-9743",
            "fax_number": "203-286-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 LAKESIDE BOULEVARD EAST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-753-9743",
            "fax_number": "203-286-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "REBECCA",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "079522",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT",
            "identifier": "140002791CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.