Active NPI
Chelsea Alexandra Hepburn, LCSW
- Clinical Social Worker
- Southbury, CT
National Provider Identifier
1669076519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12211
- Practice address
- 519 Heritage Rd Ste 1H
Southbury, CT 06488-1699 - Phone
- (203) 490-8208
- NPI assigned
- Nov 22, 2020
- 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 | 12211 | CT | Primary |
Addresses
Primary practice location
519 Heritage Rd Ste 1H
Southbury, CT 06488-1699
Mailing address
89 Andrew Ave
Naugatuck, CT 06770-4320
Phone (475) 329-1075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12211 | CT | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mellahealth LLC | Clinical | Current | Accepting new patients |
| Intrinsic Bloom, LLC | Clinical | Current | Accepting new patients |
| Ruby Psychiatric Services, PLLC | Past | Accepting new patients |
Locations
125 Lasalle Rd
Ste 300
West Hartford, CT 06107
Phone (860) 342-8192
Organizations & group practices 3
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.
-
- Clinical Social Worker
- Woodbury, CT
- NPI 1962336594
-
- Psychiatric/Mental Health Nurse Practitioner
- West Hartford, CT
- NPI 1295564425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1669076519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 ANDREW AVE",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067704320",
"telephone_number": "475-329-1075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 HERITAGE RD STE 1H",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "064881699",
"telephone_number": "203-490-8208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEPBURN",
"first_name": "CHELSEA",
"middle_name": "ALEXANDRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-22",
"last_updated": "2022-05-05",
"certification_date": "2022-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "12211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.