A Big Life LLC

Organization Active NPI Clinical Social Worker · Trumbull, CT

NPI 1245034669 · NPPES record last updated Apr 3, 2025

Key facts

NPI
1245034669
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
A BIG LIFE LLC
Practice address
92 Richfield Rd
Trumbull, CT 06611-3433
Phone
(203) 208-8541
NPI assigned
Apr 3, 2025
Organization subpart
No

Authorized official

Name
Mrs. Melissa Divito, LCSW NPI 1164064614
Title
Owner
Phone
(203) 208-8541

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260420000070 CT Part B Supplier - Clinic/Group Practice 4688140445 Receives reassigned benefits from 1 practitioner
Practice locations: Trumbull, CT

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X Yes

Addresses

Primary practice location

92 Richfield Rd
Trumbull, CT 06611-3433

Mailing address

92 Richfield Rd
Trumbull, CT 06611-3433
Phone (860) 670-5171

Other providers in Trumbull, CT

All providers in Trumbull, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.