Individual provider Active NPI

Maria Elena Galvin, LCSW

  • Clinical Social Worker
  • Bridgeport, CT
National Provider Identifier
1265748677
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006757 Issued in CT
Practice address
1635 Central Ave
Southwest CT Mental Health System
Bridgeport, CT 06610
Phone
(203) 551-7660
Fax
(203) 551-7481
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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 006757 CT Primary

Addresses

Primary practice location

1635 Central Ave
Southwest CT Mental Health System
Bridgeport, CT 06610

Mailing address

1635 Central Ave - Room 213 Attn: Sandra Grazynski
Southwest CT Mental Health System
Bridgeport, CT 06610
Phone (203) 551-7660

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
I20101118001244 CT Practitioner - Clinical Social Worker 1951597764 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006757CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Aug 30, 2010 Accepting new patients
State of Connecticut CurrentSince Aug 30, 2010 Accepting new patients
State of Connecticut CurrentSince Apr 7, 2024 Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

1635 Central Ave
Rm 213
Bridgeport, CT 06610
Phone (203) 551-7660

1635 Central Ave
#213
Bridgeport, CT 06610

165 Capitol Ave
Ste 2000
Hartford, CT 06106

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Organizations & group practices 3

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1265748677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVE - ROOM 213 ATTN: SANDRA GRAZYNSKI",
            "address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVE",
            "address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVIN",
        "first_name": "MARIA",
        "middle_name": "ELENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.