Gina M Acosta, LCSW
Individual provider Active NPI Clinical Social Worker · Bridgeport, CT
NPI 1366022923 · NPPES record last updated Apr 8, 2021
Key facts
- NPI
- 1366022923
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 011321 (CT)
- Practice address
- 3715 Main St Ste 410
Bridgeport, CT 06606-3620 - Phone
- (203) 612-4300
- NPI assigned
- Apr 8, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011321 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunrise Therapy Services LLC | Past | Accepting new patients | |
| Irma Camacho LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 011321 | CT | Yes |
Addresses
Primary practice location
3715 Main St Ste 410
Bridgeport, CT 06606-3620
Mailing address
3715 Main St Ste 410
Bridgeport, CT 06606-3620
Other providers in Bridgeport, CT
- Access Recovery LLC
- Accumedica, LLC
- Gisselle Acevedo
- Maheep Chowdary Achanta
- Jonathan P Ackley
- Erica Lynn Acquarulo
- Madeline Acquilano
- Harry Adamakos
- Barbara Addi
- Babajide Adebusoye
All providers in Bridgeport, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.