Marc Trivella, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005010 Issued in CT

Practice address

55 West Main Street
Suite 410 Western Connecticut Mental Health Network
Waterbury, CT 06702

Phone

(203) 805-6408

Fax

(203) 805-6432

NPI assigned

Nov 3, 2006

Sex

Male

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Waterbury, CT
  • NPI 1841225489
  Medicare reassignment

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700965688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "SUITE 410 WESTERN CONNECTICUT MENTAL HEALTH NETWORK",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6408",
            "fax_number": "203-805-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "SUITE 410 WESTERN CONNECTICUT MENTAL HEALTH NETWORK",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6408",
            "fax_number": "203-805-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVELLA",
        "first_name": "MARC",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Tripodi, BA
• Sridevi Tripuraneni
• Triumph Through Transitions LLC
• Trocchi Family Optometry
• Domenico Trocchi, OD
• Jeffrey Troche
• Sara Troland, LMFT
• Te'Aris Trotman

• Clinical Social Worker in Waterbury, CT
• Providers in Waterbury, 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 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.

Verify at the official NPI Registry.