Active NPI
Vickie Pagan
- Clinical Social Worker
- Milford, CT
National Provider Identifier
1609509561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 012213
- Practice address
- 117 Cascade Blvd Apt 107
Milford, CT 06460-2877 - Phone
- (203) 209-7939
- NPI assigned
- Jul 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 012213 | CT | Primary |
Addresses
Primary practice location
117 Cascade Blvd Apt 107
Milford, CT 06460-2877
Mailing address
117 Cascade Blvd Apt 107
Milford, CT 06460-2877
Phone (203) 209-7939
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1095 B S Main St
Cheshire, CT 06410-3432
Phone (203) 565-2832
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012213 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Second Stories Counseling, LLP | Current | Accepting new patients |
Locations
1095 S Main St
#B
Cheshire, CT 06410
Phone (203) 565-2832
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Cheshire, CT
- NPI 1902472541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1609509561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 CASCADE BLVD APT 107",
"city": "MILFORD",
"state": "CT",
"postal_code": "064602877",
"telephone_number": "203-209-7939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 CASCADE BLVD APT 107",
"city": "MILFORD",
"state": "CT",
"postal_code": "064602877",
"telephone_number": "203-209-7939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGAN",
"first_name": "VICKIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "012213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.