Individual provider Active NPI

Jason Defreitas, MSW,BA,LMSW

  • Social Worker
  • Danbury, CT
National Provider Identifier
1295100477
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2688 Issued in CT
Practice address
72 West St
Danbury Clinical Services
Danbury, CT 06810-6531
Phone
(203) 797-9778
Fax
(293) 797-9858
NPI assigned
Dec 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2688 CT Primary

Addresses

Primary practice location

72 West St
Danbury Clinical Services
Danbury, CT 06810-6531

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other identifiers 13

IdentifierTypeStateIssuer
060669107OtherCTANTHEM BCBS OF CT WELLMORE GRP/FACILITY
PENDINGOtherCTAETNA BEHAVIORAL HEALTH
060669107OtherCTHEALTHYCT WELLMORE FACILITY/GRP
060669107OtherCTUBH-OXFORD LIBERTY/FREEDOM WELLMORE GRP/FACILITY
PENDINGOtherCTCIGNA BEHAVIORAL HEALTH
060669107OtherCTUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
060669107OtherCTUBH-CONNECTICARE WELLMORE GRP/FACILITY
060669107OtherCTUBH-UNITED HEALTHCARE
D339229 -DANBURYOtherCTBEACON HEALTH STRATEGIES
NOT ELIGIBLEOtherCTMHN NETWORK
008064337MedicaidCT
NOT ELIGIBLEOtherCTMHN-TRICARE NOTH
13671433OtherCTCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1295100477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 WEST ST",
            "address_2": "DANBURY CLINICAL SERVICES",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106531",
            "telephone_number": "203-797-9778",
            "fax_number": "293-797-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFREITAS",
        "first_name": "JASON",
        "credential": "MSW,BA,LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-14",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "2688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT  WELLMORE FACILITY/GRP",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-OXFORD LIBERTY/FREEDOM WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-CONNECTICARE   WELLMORE GRP/FACILITY",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-UNITED HEALTHCARE",
            "identifier": "060669107",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "D339229 -DANBURY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN NETWORK",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008064337",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN-TRICARE NOTH",
            "identifier": "NOT ELIGIBLE",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13671433",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.