Individual provider Active NPI

Jeanette Laureano, LCSW

  • Clinical Social Worker
  • Bridgeport, CT
National Provider Identifier
1316355050
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008007 Issued in CT
Practice address
44 Ashton St
Bridgeport, CT 06606-2613
Phone
(203) 455-7813
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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 008007 CT Primary

Addresses

Primary practice location

44 Ashton St
Bridgeport, CT 06606-2613

Mailing address

44 Ashton St
Bridgeport, CT 06606-2613
Phone (203) 455-7813

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
I20160817001453 CT Practitioner - Clinical Social Worker 6608161559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

1635 Central Ave
Bridgeport, CT 06610-2717
Phone (203) 551-7464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jun 18, 2016 Accepting new patients
State of Connecticut CurrentSince Jun 18, 2016 Accepting new patients

Locations

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

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Organizations & group practices 2

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1316355050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 ASHTON ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062613",
            "telephone_number": "203-455-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 ASHTON ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062613",
            "telephone_number": "203-455-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUREANO",
        "first_name": "JEANETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.