Individual provider Active NPI

Erin E McCormack, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1265681241
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006565 Issued in CT
Practice address
1309 S Main St
Waterbury, CT 06706-1758
Phone
(203) 756-8021
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 006565 CT Primary

Addresses

Primary practice location

1309 S Main St
Waterbury, CT 06706-1758

Mailing address

30 Main St
FL 1
East Haven, CT 06512-2506
Phone (203) 927-5130

Other names 1

  • Erin McCormack Professional name

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
I20130723000391 CT Practitioner - Clinical Social Worker 4486895190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 Main St
FL 1
East Haven, CT 06512-2506
Phone (203) 927-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006565CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Perspective Clinical Services, PC Clinical CurrentSince Aug 25, 2014 Accepting new patients
Sunrise Psychological Services LLC CurrentSince Jul 27, 2019 Accepting new patients

Locations

30 Main St
#1
East Haven, CT 06512
Phone (203) 927-5130

55 Grand St
New Britain, CT 06052
Phone (845) 459-5767

163 Quinnipiac Ave
North Haven, CT 06473
Phone (203) 624-3303

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1265681241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "address_2": "FL 1",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122506",
            "telephone_number": "203-927-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061758",
            "telephone_number": "203-756-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "ERIN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "MCCORMACK",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.