Jessica Marie Sousa-Santos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009701 Issued in CT

Practice address

304 Federal Rd Ste 312
Brookfield, CT 06804-2419

Phone

(203) 826-4262

Fax

(203) 546-7082

NPI assigned

Jul 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Support: You

  • Adult Mental Health Clinic/Center
  • Brookfield, CT
  • NPI 1821737446
  Medicare reassignment NPD Authorized official
• Connecticut Institute for Communities Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1780918045
  Medicare reassignment NPD
• Connecticut Institute for Communities Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1528499969
  NPD

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1326534918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 FEDERAL RD STE 312",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042419",
            "telephone_number": "203-826-4262",
            "fax_number": "203-546-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 FEDERAL RD STE 312",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042419",
            "telephone_number": "203-826-4262",
            "fax_number": "203-546-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUSA-SANTOS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Vijay Soares
• Craig T Sollose, D.C
• Lori Elizabeth Sollose, L.C.S.W.
• Shivani Sunil Soni
• Sophia Natural Health Center
• Steven Alan Springer, D.D.S.
• Stafferzz Network
• Heather Stafford, MSTCM, L.AC.
• Christina B Stauble, M.S. CCC-SLP
• Michael L. Stern, PHD

• Clinical Social Worker in Brookfield, CT
• Providers in Brookfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.