Individual provider Active NPI

Heather Child Quercia, LICSW AND LCSW

  • Clinical Social Worker
  • Putnam, CT
National Provider Identifier
1366955007
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9428 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
NPI assigned
Nov 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X ISW02748 RI
Clinical Social Worker 1041C0700X 9428 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

PO Box 64
East Woodstock, CT 06244-0064
Phone (860) 576-3092

Other practice location 1

554 Liberty Hwy Ste 3
Putnam, CT 06260-2728
Phone (860) 576-3092

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
I20260611000137 CT Practitioner - Clinical Social Worker 7113499179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

40 Mansfield Ave
Willimantic, CT 06226-2018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW02748RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reflective Counseling, LLC Clinical Past Accepting new patients

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": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1366955007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "EAST WOODSTOCK",
            "state": "CT",
            "postal_code": "062440064",
            "telephone_number": "860-576-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 Liberty Hwy Ste 3",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062602728",
            "country_code": "US",
            "telephone_number": "860-576-3092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUERCIA",
        "first_name": "HEATHER",
        "middle_name": "CHILD",
        "credential": "LICSW AND LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02748",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.