Jaclyn Olivia Vanacore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13294 Issued in CT

Practice address

103 W Broad St
Stamford, CT 06902-3713

Phone

(203) 324-6127

NPI assigned

Oct 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jaclyn.vanacore@chcict.eclinicaldirectplus.com

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1407628084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023713",
            "telephone_number": "203-324-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANACORE",
        "first_name": "JACLYN",
        "middle_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shira B Vadel, MD
• Katherine Marie Vaillancourt, MD
• Justine Valentino
• Valeriemondesirlmft LLC
• Alexandra Van Duyne, BCBA
• Corinne Vanbeek, MD
• Denny Varghese, RPH
• Reinie Varkey, NP
• Julie Vanille Vasile, M.D.
• Romulo V Vasquez, MD

• Clinical Social Worker in Stamford, CT
• Providers in Stamford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.