Laurie Bowman Mucciacciaro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007651 Issued in CT

Practice address

152 Simsbury Rd
Building 9, 2ND Floor
Avon, CT 06001-3777

Phone

(860) 269-3101

Fax

(860) 269-3102

NPI assigned

Jan 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laurie Marie Bowman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Vista Behavioral Health, LLC

  • Psychiatry Physician
  • Avon, CT
  • NPI 1225297690
  NPD (past)

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1760805808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SIMSBURY RD",
            "address_2": "BUILDING 9, 2ND FLOOR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013777",
            "telephone_number": "860-269-3101",
            "fax_number": "860-269-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 SIMSBURY RD",
            "address_2": "BUILDING 9, 2ND FLOOR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013777",
            "telephone_number": "860-269-3101",
            "fax_number": "860-269-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCIACCIARO",
        "first_name": "LAURIE",
        "middle_name": "BOWMAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "BOWMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Motivate Health Care
• Jessica Mount, LCSW
• Mountain Physical Therapy and Sports Medicine, LLC
• Samuel Moy, PH.D.
• Danielle Moynihan
• Lalarukh Mufti, M.D.
• Katherine Mugno
• Nancy Mullen
• Brianna Munoz, DMD, MPH
• Gabriella Muratori

• Clinical Social Worker in Avon, CT
• Providers in Avon, 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 24, 2014; 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.