Active NPI
Alicia Wendy Feller, LCSW
- Clinical Social Worker
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005501
- Practice address
- 1635 Central Avenue
Southwest CT Mental Health System
Bridgeport, CT 06610 - Phone
- (203) 551-7660
- Fax
- (203) 551-7481
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 005501 | CT | Primary |
Addresses
Primary practice location
1635 Central Avenue
Southwest CT Mental Health System
Bridgeport, CT 06610
Mailing address
1635 Central Avenue
Southwest CT Mental Health System RM 213 Attn Sandra GR
Bridgeport, CT 06610
Phone (203) 551-7660
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501 | CT | MD | Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Current | Accepting new patients | |
| State of Connecticut | Current | Accepting new patients |
Locations
1635 Central Ave
Rm 213
Bridgeport, CT 06610
Phone (203) 551-7660
1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464
450 Columbus Blvd
Ste 1001
Hartford, CT 06103
55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408
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.
-
dba Southwest Connecticut Mental Health System
- Psychiatric Hospital
- Bridgeport, CT
- NPI 1720013360
-
dba Department of Veterans' Affairs, Veterans Home
- Skilled Nursing Facility
- Rocky Hill, CT
- NPI 1205951662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700963311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 CENTRAL AVENUE",
"address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM RM 213 ATTN SANDRA GR",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06610",
"telephone_number": "203-551-7660",
"fax_number": "203-551-7481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 CENTRAL AVENUE",
"address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06610",
"telephone_number": "203-551-7660",
"fax_number": "203-551-7481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELLER",
"first_name": "ALICIA",
"middle_name": "WENDY",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.