Individual provider Active NPI

Claudia A Vazquez-Carmona, LCSW

  • Clinical Social Worker
  • New London, CT
National Provider Identifier
1285123554
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
255 Hempstead St
New London, CT 06320
Phone
(860) 443-2896
Fax
(860) 442-5909
NPI assigned
May 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

255 Hempstead St
New London, CT 06320

Mailing address

255 Hempstead St
New London, CT 06320-6290
Phone (860) 443-2896

Other names 1

  • Claudia A Carmona Botero Former 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
I20230420001428 CT Practitioner - Clinical Social Worker 7416312749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Claudia Carmona Psychotherapy, LLC Clinical Current Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Apr 6, 2023 Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Apr 6, 2023 Accepting new patients

Locations

591 Poquonnock Rd
Groton, CT 06340
Phone (860) 449-8217

255 Hempstead St
New London, CT 06320

7 Vauxhall St
New London, CT 06320
Phone (860) 442-2797

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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1285123554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206290",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ-CARMONA",
        "first_name": "CLAUDIA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAUDIA",
            "last_name": "CARMONA BOTERO",
            "middle_name": "A",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.