Individual provider Active NPI

Jennifer Richmond, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1336348242
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005401 Issued in CT
Practice address
370 James St
2ND Floor
New Haven, CT 06513-3089
Phone
(203) 777-8648
Fax
(203) 785-0617
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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 005401 CT Primary

Addresses

Primary practice location

370 James St
2ND Floor
New Haven, CT 06513-3089

Mailing address

370 James St
2ND Floor
New Haven, CT 06513-3089
Phone (203) 777-8648

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

State licenses

LicenseStateTypeSpecialty
005401CTMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1336348242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 JAMES ST",
            "address_2": "2ND FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133089",
            "telephone_number": "203-777-8648",
            "fax_number": "203-785-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 JAMES ST",
            "address_2": "2ND FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133089",
            "telephone_number": "203-777-8648",
            "fax_number": "203-785-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.