Individual provider Active NPI

Rebekah Jaine Terwilliger, LCSW

  • Clinical Social Worker
  • Newington, CT
National Provider Identifier
1750121877
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14058 Issued in CT
Practice address
555 Willard Ave
Newington, CT 06111-2631
Phone
(860) 667-6734
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 14058 CT Primary

Addresses

Primary practice location

555 Willard Ave
Newington, CT 06111-2631

Mailing address

67 Collier Ave
Bristol, CT 06010-4447
Phone (985) 237-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1750121877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 COLLIER AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104447",
            "telephone_number": "985-237-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "860-667-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERWILLIGER",
        "first_name": "REBEKAH",
        "middle_name": "JAINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.