Hector G Lizcano, LCSW LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003861 Issued in CT

Practice address

904 State St
New Haven, CT 06511-3921

Phone

(203) 624-7710

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Psychotherapy Services LLC

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1720628969
  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1720143951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 MAPLE ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054517",
            "telephone_number": "203-494-0333",
            "fax_number": "203-974-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 STATE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113921",
            "telephone_number": "203-624-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZCANO",
        "first_name": "HECTOR",
        "middle_name": "G",
        "credential": "LCSW LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "LADC 000190",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "LCSW003861",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaozhou Liu, M.D.
• Alison Claire Livada, MD, PHD
• Juan Jose Lizardi
• Ana Maria Lizcano, M.A.
• Diana Lizcano, PSY.D.
• Rachita Das Llona, MD, MPH, MS
• Xavier Llor, M.D.
• Bryan Lo
• Emma Ava Lo, MD
• Lisa Lochner, LCSW

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, 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 Jan 22, 2020; 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.