Individual provider Active NPI

Taylor Libera, LCSW

  • Social Worker
  • Waterbury, CT
National Provider Identifier
1518688571
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
855 Lakewood Rd
Waterbury, CT 06704-5408
Phone
(860) 410-2228
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

855 Lakewood Rd
Waterbury, CT 06704-5408

Mailing address

855 Lakewood Rd
Waterbury, CT 06704-5408
Phone (860) 410-2228

Other identifiers 1

IdentifierTypeStateIssuer
VKW005M90262OtherCTANTHEM

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
I20250320002347 CT Practitioner - Clinical Social Worker 9830611656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

855 Lakewood Rd
Waterbury, CT 06704-5408
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeler Clinic Inc CurrentSince Feb 13, 2025 Accepting new patients
Wheeler Clinic Inc CurrentSince Feb 13, 2025 Accepting new patients

Locations

91 Northwest Dr
Plainville, CT 06062
Phone (860) 793-3871

855 Lakewood Rd
Waterbury, CT 06704
Phone (860) 414-2504

Interoperability endpoints

  • Direct secure messaging: taylor.corazzo.p1@direct.wheelerclinic.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1518688571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067045408",
            "telephone_number": "860-410-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067045408",
            "telephone_number": "860-410-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERA",
        "first_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "VKW005M90262",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.