Active NPI
Jonathan Adam Spears, LCSW
- Clinical Social Worker
- Bridegport, CT
National Provider Identifier
1346412996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 050572-1
- Practice address
- 180 Fairfield Ave
Child Guidance Center
Bridegport, CT 06604 - Phone
- (203) 394-6529
- NPI assigned
- Mar 24, 2008
- Last updated
- Mar 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 050572-1 | NY | Primary |
Addresses
Primary practice location
180 Fairfield Ave
Child Guidance Center
Bridegport, CT 06604
Mailing address
205 Beaumont St
Fairfield, CT 06824-5746
Phone (203) 255-7060
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
| License | State | Type | Specialty |
|---|---|---|---|
| 050572-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1346412996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 BEAUMONT ST",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245746",
"telephone_number": "203-255-7060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 FAIRFIELD AVE",
"address_2": "CHILD GUIDANCE CENTER",
"city": "BRIDEGPORT",
"state": "CT",
"postal_code": "06604",
"telephone_number": "203-394-6529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARS",
"first_name": "JONATHAN",
"middle_name": "ADAM",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-24",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "050572-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridegport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.