Amanda S Riccitelli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12570 Issued in CT

Practice address

2960 Post Rd FL 3
Southport, CT 06890-1268

Phone

(203) 307-3030

NPI assigned

Nov 2, 2022

Last updated

Nov 2, 2022By the provider in NPPES

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

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Coastal Connecticut Counseling LLCGroup PAC ID 8527361161, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coastal Connecticut Counseling LLC

  • Marriage & Family Therapist
  • Southport, CT
  • NPI 1982076014
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1568179166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 POST RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 POST RD FL 3",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901268",
            "telephone_number": "203-307-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCITELLI",
        "first_name": "AMANDA",
        "middle_name": "S",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Duncan Ramaley, M.D.
• Breanna Lyn Razdan, D.C.
• RCS Fairfield
• RCS Fairfield (Reliant Compounded Solutions)
• Michael Joseph Reynolds, D.D.S.
• Samantha Rijos
• Gerald Herbert Ringel, RPH
• Robbins Eye Center PC (Sasco Hill Surgery Center)
• Robert H Rogers III
• Heather Lyn Rosenbaum, LCSW

• Clinical Social Worker in Southport, CT
• Providers in Southport, 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 Nov 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.