Individual provider Active NPI

Jessica Byers, LCSW

  • Clinical Social Worker
  • Bristol, CT
National Provider Identifier
1639440969
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005193 Issued in CT
Practice address
440 N Main St Ste C
Bristol, CT 06010-1902
Phone
(860) 583-5858
NPI assigned
Jan 18, 2012
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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 005193 CT Primary

Addresses

Primary practice location

440 N Main St Ste C
Bristol, CT 06010-1902

Mailing address

440 N Main St Ste C
Bristol, CT 06010-1902
Phone (860) 583-5858

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
I20150623001727 CT Practitioner - Clinical Social Worker 0749591386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

325 S Main St
Cheshire, CT 06410-3159
Phone (203) 651-9255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Change Therapy, PLLC Clinical CurrentSince Nov 1, 2019 Accepting new patients

Locations

325 S Main St
Cheshire, CT 06410
Phone (203) 271-1541

325 S Main St
Ste 1
Cheshire, CT 06410

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, 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": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1639440969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N MAIN ST STE C",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060101902",
            "telephone_number": "860-583-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N MAIN ST STE C",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060101902",
            "telephone_number": "860-583-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYERS",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.