Individual provider Active NPI

Tracey Masella, LCSW

  • Clinical Social Worker
  • Westport, CT
National Provider Identifier
1346679727
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008354 Issued in CT
Practice address
5 Sylvan Rd S
Westport, CT 06880-4614
Phone
(203) 307-5788
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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 008354 CT Primary

Addresses

Primary practice location

5 Sylvan Rd S
Westport, CT 06880-4614

Mailing address

132 Fox Run Rd
New Canaan, CT 06840-2821
Phone (203) 246-8877

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
008354CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1346679727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 FOX RUN RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068402821",
            "telephone_number": "203-246-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SYLVAN RD S",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804614",
            "telephone_number": "203-307-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASELLA",
        "first_name": "TRACEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.