Individual provider Active NPI

Luis Jaramillo, LCSW

  • Clinical Social Worker
  • Cheshire, CT
National Provider Identifier
1245600451
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9210 Issued in CT
Practice address
396 S Main St
Suite 2D
Cheshire, CT 06410-1372
Phone
(860) 922-1219
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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 9210 CT Primary

Addresses

Primary practice location

396 S Main St
Suite 2D
Cheshire, CT 06410-1372

Mailing address

1564 Waterbury Rd
Cheshire, CT 06410-1331
Phone (860) 922-1219

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
I20181002001629 CT Practitioner - Clinical Social Worker 3072865062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9210CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC Clinical CurrentSince Sep 4, 2018 Accepting new patients
Luis Jaramillo Clinical Past Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1245600451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1564 WATERBURY RD",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101331",
            "telephone_number": "860-922-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 S MAIN ST",
            "address_2": "SUITE 2D",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101372",
            "telephone_number": "860-922-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "LUIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.