Individual provider Active NPI

Stephen R. Kinsella, LCSW

  • Clinical Social Worker
  • Southbury, CT
National Provider Identifier
1790816049
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006367 Issued in CT
Practice address
800 Main St S Ste 210
Southbury, CT 06488-4210
Phone
(203) 681-1212
NPI assigned
Mar 8, 2007
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 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 006367 CT Primary

Addresses

Primary practice location

800 Main St S Ste 210
Southbury, CT 06488-4210

Mailing address

100 Main St N # 125
Southbury, CT 06488-3840
Phone (914) 450-6007

Other identifiers 2

IdentifierTypeStateIssuer
11163OtherNYCASAC
73075100OtherNYLCSW

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
I20070425000539 CT Practitioner - Clinical Social Worker 6002911799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

800 Main St S
Suite 210
Southbury, CT 06488-4210
Phone (203) 681-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Perspectives Treatment Center, Inc. Clinical CurrentSince Apr 10, 2012 Accepting new patients

Locations

100 Main St N
#125
Southbury, CT 06488
Phone (203) 681-1212

100 Main St N
Ste 125
Southbury, CT 06488

800 Main St S
Ste 210
Southbury, CT 06488
Phone 2032709888103

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1790816049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN ST N # 125",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883840",
            "telephone_number": "914-450-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST S STE 210",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884210",
            "telephone_number": "203-681-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "STEPHEN",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC",
            "identifier": "11163",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "73075100",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.