Individual provider Active NPI

Desiree Emirzian, LCSW

  • Clinical Social Worker
  • Plainville, CT
National Provider Identifier
1669948428
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010803 Issued in CT
Practice address
74 East St
Plainville, CT 06062-2367
Phone
(860) 793-4213
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 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 010803 CT Primary

Addresses

Primary practice location

74 East St
Plainville, CT 06062-2367

Mailing address

91 Northwest Dr
Plainville, CT 06062-1534

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
I20210309000125 CT Practitioner - Clinical Social Worker 5395151807 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Jan 1, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Community Health Resources, Inc. CurrentSince Mar 18, 2024 Accepting new patients

Locations

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

1389 W Main St
Ste 309
Waterbury, CT 06708

2 Waterside Xing
Ste 401
Windsor, CT 06095

Interoperability endpoints

  • Direct secure messaging: desiree.emirzian.1@28623.direct.athenahealth.com

Organizations & group practices 4

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1669948428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622367",
            "telephone_number": "860-793-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMIRZIAN",
        "first_name": "DESIREE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

Verify at the official NPI Registry.