Individual provider Active NPI

Victoria Simeone, LCSW

  • Clinical Social Worker
  • Milford, CT
National Provider Identifier
1356827463
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
011267 Issued in CT
Practice address
949 Bridgeport Ave
Milford, CT 06460-3142
Phone
(203) 878-6365
Fax
(203) 301-2397
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 004016 CT
Clinical Social Worker 1041C0700X 011267 CT Primary

Addresses

Primary practice location

949 Bridgeport Ave
Milford, CT 06460-3142

Mailing address

949 Bridgeport Ave
Milford, CT 06460-3142
Phone (203) 878-6365

Other identifiers 1

IdentifierTypeStateIssuer
004039244MedicaidCT

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
I20210227000053 CT Practitioner - Clinical Social Worker 3971918848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011267CTMDClinical Social Worker
004016CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince Jan 1, 2021 Accepting new patients
Optimus Health Care Inc CurrentSince Jan 1, 2021 Accepting new patients

Locations

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

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

949 Bridgeport Ave
Milford, CT 06460
Phone (203) 301-2308

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1356827463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 BRIDGEPORT AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603142",
            "telephone_number": "203-878-6365",
            "fax_number": "203-301-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 BRIDGEPORT AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603142",
            "telephone_number": "203-878-6365",
            "fax_number": "203-301-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEONE",
        "first_name": "VICTORIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "004016",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004039244",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.