Individual provider Active NPI

Victoria E Brinckerhoff, MSW,BA,LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1225374945
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9065 Issued in CT
Practice address
141 E Main St
3Rd Floor Home Based Services
Waterbury, CT 06702-2310
Phone
(203) 575-0466
Fax
(203) 575-1817
NPI assigned
Dec 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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 9065 CT Primary

Addresses

Primary practice location

141 E Main St
3Rd Floor Home Based Services
Waterbury, CT 06702-2310

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other identifiers 13

IdentifierTypeStateIssuer
060669107OtherCTUBH-OXFORD HEALTH/LIBERTY/FREEDOM WELLMORE GRP/FACILITY
D339209-141 E MAINOtherCTVALUE OPTIONS
PENDINGOtherCTMHN MANAGED HEALTH NETWORK
PENDINGOtherCTMHN-TRICARE NORTH
060669107OtherCTHEALTHYCT WELLMORE GRP/FACILITY
060669107OtherCTUBH-CONNECTICUT WELLMORE GRP/FACILITY
060669107OtherCTUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
008060530MedicaidCT
PENDINGOtherCTAETNA BEHAVIORAL HEALTH
PENDINGOtherCTCIGNA BEHAVIORAL HEALTH
060669107OtherCTUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
060669107OtherCTANTHEM BCBS OF CT WELLMORE GRP/FACILITY
13646056OtherCTCAQH

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
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1225374945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "3RD FLOOR HOME BASED SERVICES",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-575-0466",
            "fax_number": "203-575-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINCKERHOFF",
        "first_name": "VICTORIA",
        "middle_name": "E",
        "credential": "MSW,BA,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-OXFORD HEALTH/LIBERTY/FREEDOM   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "D339209-141 E MAIN",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN MANAGED HEALTH NETWORK",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN-TRICARE NORTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT     WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-CONNECTICUT     WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008060530",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-UNITED HEALTHCARE          WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT    WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13646056",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.