Individual provider Active NPI

Jennifer Jester Coffman, LCSW

  • Clinical Social Worker
  • Westport, CT
National Provider Identifier
1780479477
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15125 Issued in CT
Practice address
21 Dover Rd
Westport, CT 06880-2627
Phone
(646) 918-0281
NPI assigned
Apr 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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 15125 CT Primary

Addresses

Primary practice location

21 Dover Rd
Westport, CT 06880-2627

Mailing address

21 Dover Rd
Westport, CT 06880-2627
Phone (646) 918-0281

Other practice location 1

30 Old Kings Hwy S
Darien, CT 06820-4526
Phone (203) 208-9785

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509002955 CT Practitioner - Clinical Social Worker 4789101916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15125CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Darien Wellness CurrentSince Apr 10, 2025 Accepting new patients

Locations

30 Old Kings Hwy S
Darien, CT 06820
Phone (203) 654-9094

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1780479477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DOVER RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802627",
            "telephone_number": "646-918-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DOVER RD",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802627",
            "telephone_number": "646-918-0281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Old Kings Hwy S",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "CT",
            "postal_code": "068204526",
            "country_code": "US",
            "telephone_number": "203-208-9785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "JENNIFER",
        "middle_name": "JESTER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-12",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.