Individual provider Active NPI

Jennifer Ann Lewis, LCSW

  • Clinical Social Worker
  • Windsor, CT
National Provider Identifier
1376669648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004753 Issued in CT
Practice address
32 Maple Ave
Windsor, CT 06095-2922
Phone
(860) 722-3273
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 004753 CT Primary

Addresses

Primary practice location

32 Maple Ave
Windsor, CT 06095-2922

Mailing address

32 Maple Ave
Windsor, CT 06095-2922
Phone (860) 722-3273

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
I20181115000964 CT Practitioner - Clinical Social Worker 0749534410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4753CTMDOccupational Therapist
004753CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Clinical CurrentSince Sep 4, 2018 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376669648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 MAPLE AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952922",
            "telephone_number": "860-722-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MAPLE AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952922",
            "telephone_number": "860-722-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.