Jennifer Root, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008779 Issued in CT

Practice address

139 Hazard Ave
Building 2/Unit 8
Enfield, CT 06082-4585

Phone

(860) 933-7311

NPI assigned

Jun 5, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 20, 2024 through Jun 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jennifer Root, LLC

  • Community/Behavioral Health Agency
  • Enfield, CT
  • NPI 1205212172
  NPD (past) Authorized official

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1447630306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4074 MOUNTAIN RD",
            "city": "WEST SUFFIELD",
            "state": "CT",
            "postal_code": "060932118",
            "telephone_number": "860-604-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HAZARD AVE",
            "address_2": "BUILDING 2/UNIT 8",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824585",
            "telephone_number": "860-933-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Rogers
• Shanele Rogers
• Olivia Rose Rolocut
• Mary Lou Romano
• Sandra Romano
• Rosemarie Thompson, Rd
• Ross Porter (Enfield Pediatric Associates)
• Robert A Rossetti, DMD, MD
• Izabela Roszkowska
• Amy Beth Rothenberg, ND NATUROPATHIC DOCT

• Clinical Social Worker in Enfield, CT
• Providers in Enfield, 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 Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.