Melissa Wortham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14887 Issued in CT

Practice address

171 Market SQ Ste 206a
Newington, CT 06111-2930

Phone

(860) 845-1503

NPI assigned

Dec 11, 2021

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• New Provenance Counseling Center, LLC

  • Clinical Social Worker
  • Newington, CT
  • NPI 1457949687
  NPD

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1659030237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MARKET SQ STE 206A",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MARKET SQ STE 206A",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112930",
            "telephone_number": "860-845-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-11",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Wilson, PHARMD
• David Wogelius, R.PH.
• Karen Wojcik, PT
• Kyle Wolf, DPT
• Maureen Marie Worley, APRN
• Michelle Marie Wortham, LCSW
• James Woznicki, PT
• Maria Wren, M.S.W., L.C.S.W
• Karolina A. Wytrykowska, LPC, LADC
• Turgut Yetil, M.D.

• Clinical Social Worker in Newington, CT
• Providers in Newington, 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 Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.