Laurence Fernandez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009632 Issued in CT

Practice address

97 Middle St
Bridgeport, CT 06604-4410

Phone

(203) 579-7368

NPI assigned

Nov 6, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• State of Connecticut

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434
  Medicare reassignment

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1285102301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ADLA DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141806",
            "telephone_number": "347-666-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 MIDDLE ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044410",
            "telephone_number": "203-579-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "LAURENCE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia W Fernandes, LMSW
• John Fernandes Jr., MSW, LMSW
• Ximena Pia Fernandez Lango, MD
• Bianca Celyn Fernandez, OTR/L
• Joanna R Fernandez, APRN
• Diana Rachel Stern Ferrante, DO
• Kristin Ferrara, BA
• Alexander Ferravante III, PA-C
• Amanda Ferreira
• Heather Ferrillo, APRN

• Clinical Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.