Individual provider Active NPI

Theresa Lynn Villani, LCSW

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1346410511
Registry record updated Apr 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10598 Issued in CT
Practice address
1351 Washington Blvd
Stamford, CT 06902
Phone
(203) 621-3750
NPI assigned
Mar 4, 2008
Last updated
Apr 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2024

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 10598 CT Primary

Addresses

Primary practice location

1351 Washington Blvd
Stamford, CT 06902

Mailing address

1351 Washington Blvd
Stamford, CT 06902-2419
Phone (203) 621-3750

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
I20190618002515 CT Practitioner - Clinical Social Worker 1153491790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 576-3885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince May 8, 2019 Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

Locations

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

1351 Washington Blvd
Stamford, CT 06902
Phone (203) 276-7464

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, 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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1346410511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 WASHINGTON BLVD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022419",
            "telephone_number": "203-621-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 WASHINGTON BLVD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-621-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANI",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.