Individual provider Active NPI

Melody Lynn Poma, LCSW

  • Clinical Social Worker
  • Bridgeport, CT
National Provider Identifier
1326283573
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006570 Issued in CT
Practice address
1635 Central Ave.
Southwest CT Mental Health System
Bridgeport, CT 06610
Phone
(203) 551-7660
NPI assigned
Dec 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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 006570 CT Primary

Addresses

Primary practice location

1635 Central Ave.
Southwest CT Mental Health System
Bridgeport, CT 06610

Mailing address

1635 Central Avenue
Southwest CT. Mental Health System
Bridgeport, CT 06610
Phone (203) 551-7660

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
I20101220001157 CT Practitioner - Clinical Social Worker 4789872540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
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

State licenses

LicenseStateTypeSpecialty
006570CTMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1326283573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "SOUTHWEST CT. MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVE.",
            "address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMA",
        "first_name": "MELODY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.