Heather Lyn Rosenbaum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

010177 Issued in CT

Practice address

201 Hulls Hwy
Southport, CT 06890-1183

Phone

(203) 640-0777

NPI assigned

Apr 21, 2022

Last updated

Apr 21, 2022By the provider in NPPES

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

Other identifiers 1

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Christian Counseling and Family Life Center, Inc.Group PAC ID 4688637010, 9 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Christian Counseling and Family Life Center, Inc.

  • Marriage & Family Therapist
  • Shelton, CT
  • NPI 1740313568

  Clinical

  Medicare reassignment Care Compare group NPD
• Heather Rosenbaum Therapy Services

  • Clinical Social Worker
  • Weston, CT
  • NPI 1922895341
  NPD Authorized official

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1356085765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HULLS HWY",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901183",
            "telephone_number": "203-640-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HULLS HWY",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901183",
            "telephone_number": "203-640-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "HEATHER",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "010177",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda S Riccitelli, LCSW
• Samantha Rijos
• Gerald Herbert Ringel, RPH
• Robbins Eye Center PC (Sasco Hill Surgery Center)
• Robert H Rogers III
• Rebecca J Ruff
• Sabita Holistic Center
• Barbara Sager, MD
• Jennifer Salkin, LMFT
• Salvatore M Pizzino & Associates

• Clinical Social Worker in Southport, CT
• Providers in Southport, 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 21, 2022; 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.