Individual provider Active NPI

Benjamin Mindaro Yambao, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1649925751
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15321 Issued in CT
Practice address
255 Bank St FL 4
Waterbury, CT 06702-2219
Phone
(203) 596-9724
NPI assigned
Feb 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 15321 CT Primary

Addresses

Primary practice location

255 Bank St FL 4
Waterbury, CT 06702-2219

Mailing address

255 Bank St FL 4
Waterbury, CT 06702-2219
Phone (203) 596-9724

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
I20250630000539 CT Practitioner - Clinical Social Worker 3476066838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15321CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Affiliates Inc CurrentSince May 22, 2025 Accepting new patients
Flourish to Better Health, LLC Clinical Past Accepting new patients

Locations

233 Main St
Fl 6
New Britain, CT 06051

233 Main St
New Britain, CT 06051
Phone (860) 224-8192

255 Bank St
Fl 4
Waterbury, CT 06702
Phone (203) 596-9724

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": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1649925751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 BANK ST FL 4",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022219",
            "telephone_number": "203-596-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BANK ST FL 4",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022219",
            "telephone_number": "203-596-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMBAO",
        "first_name": "BENJAMIN",
        "middle_name": "MINDARO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.