Individual provider Active NPI

Jessica Lewis, LCSW

  • Clinical Social Worker
  • Fairfield, CT
National Provider Identifier
1295193241
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00854 Issued in CT
Practice address
1525 Kings Hwy Ste 206
Fairfield, CT 06824-5321
Phone
(203) 220-6595
NPI assigned
Feb 5, 2016
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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 00854 CT Primary

Addresses

Primary practice location

1525 Kings Hwy Ste 206
Fairfield, CT 06824-5321

Mailing address

762 Post Rd
Darien, CT 06820-4719
Phone (203) 883-0464

Other practice location 1

762 Post Rd
Darien, CT 06820-4719
Phone (203) 883-0464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240327003087 CT Practitioner - Clinical Social Worker 2668819558 Reassigns benefits to 1 organization
I20240403004106 CO Practitioner - Clinical Social Worker 2668819558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darien WellnessGroup PAC ID 4981052024, 8 clinicians

Practice addresses (Care Compare)

1434 Spruce St
Suite 119
Boulder, CO 80302-4815
Phone (720) 653-3003

30 Old Kings Hwy S
Darien, CT 06820-4551
Phone (203) 883-0464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00854CTMDClinical Social Worker
8574CTMDPharmacist

Interoperability endpoints

  • Direct secure messaging: jessica.lewis@xdr.hhchealthdirect.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1295193241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 POST RD",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204719",
            "telephone_number": "203-883-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 KINGS HWY STE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245321",
            "telephone_number": "203-220-6595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "762 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "CT",
            "postal_code": "068204719",
            "country_code": "US",
            "telephone_number": "203-883-0464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "00854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.