Individual provider Active NPI

Lauren Olivia Gibson-Carter, LCSW

  • Clinical Social Worker
  • Bloomfield, CT
National Provider Identifier
1376776682
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005784 Issued in CT
Practice address
3 Barnard LN
Suite 107
Bloomfield, CT 06002-2452
Phone
(860) 874-9995
Fax
(860) 578-9173
NPI assigned
Sep 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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 005784 CT Primary

Addresses

Primary practice location

3 Barnard LN
Suite 107
Bloomfield, CT 06002-2452

Mailing address

3 Barnard LN
Suite 107
Bloomfield, CT 06002-2452
Phone (860) 874-9995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005784CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1376776682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BARNARD LN",
            "address_2": "SUITE 107",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022452",
            "telephone_number": "860-874-9995",
            "fax_number": "860-578-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BARNARD LN",
            "address_2": "SUITE 107",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022452",
            "telephone_number": "860-874-9995",
            "fax_number": "860-578-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON-CARTER",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.