Individual provider Active NPI

Theo Pinnow, LCSW

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1497612659
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16176 Issued in CT
Practice address
103 W Broad St
Stamford, CT 06902-3713
Phone
(203) 324-6127
NPI assigned
Jan 8, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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 16176 CT Primary

Addresses

Primary practice location

103 W Broad St
Stamford, CT 06902-3713

Mailing address

103 W Broad St
Stamford, CT 06902-3713

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
I20260310002079 CT Practitioner - Clinical Social Worker 2264915107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 Grand St
Middletown, CT 06457-2705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16176CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Jan 12, 2026 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": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1497612659",
    "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": "PINNOW",
        "first_name": "THEO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "16176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.