Individual provider Active NPI

Jay Edward Souza-Erlandson, LCSW

  • Clinical Social Worker
  • East Lyme, CT
National Provider Identifier
1255115226
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15405 Issued in CT
Practice address
205 Buoy LN
East Lyme, CT 06333-1777
Phone
(401) 315-4538
NPI assigned
Aug 22, 2023
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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 15405 CT Primary

Addresses

Primary practice location

205 Buoy LN
East Lyme, CT 06333-1777

Mailing address

205 Buoy LN
East Lyme, CT 06333-1777
Phone (401) 315-4538

Other practice location 1

75 Granite St
New London, CT 06320-5770
Phone (860) 245-9372

Other practice location 2

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Other practice location 3

132 Windham Avenue
Willimantic, CT 06226
Phone (860) 465-3490

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
I20251028000106 CT Practitioner - Clinical Social Worker 9133618598 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15405CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Windham Community Memorial Hospital, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Onda Calma Wellness Clinical CurrentSince Jun 15, 2025 Accepting new patients
The William W Backus Hospital Current Accepting new patients
The William W Backus Hospital CurrentSince Sep 1, 2025 Accepting new patients
William W Backus Hospital CurrentSince Sep 1, 2025 Accepting new patients
Onda Harbor Counseling PastSince Jun 15, 2025 Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1255115226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BUOY LN",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331777",
            "telephone_number": "401-315-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BUOY LN",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331777",
            "telephone_number": "401-315-4538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Granite St",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063205770",
            "country_code": "US",
            "telephone_number": "860-245-9372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Washington St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602740",
            "country_code": "US",
            "telephone_number": "860-889-8331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "132 Windham Avenue",
            "address_purpose": "LOCATION",
            "city": "Willimantic",
            "state": "CT",
            "postal_code": "06226",
            "country_code": "US",
            "telephone_number": "860-465-3490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUZA-ERLANDSON",
        "first_name": "JAY",
        "middle_name": "EDWARD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lyme, CT

Sources for this page

Verify at the official NPI Registry.