Individual provider Active NPI

Jessica Marie Wisnieski

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1801454962
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
60 Palmers Hill Rd
Stamford, CT 06902-2113
Phone
(203) 324-3167
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 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 Primary

Addresses

Primary practice location

60 Palmers Hill Rd
Stamford, CT 06902-2113

Mailing address

71 Strawberry Hill Ave Apt 418
Stamford, CT 06902-2719
Phone (516) 776-4728

Other practice location 1

150 Glen View Ter
New Haven, CT 06515-1417
Phone (203) 770-4338

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
I20220221000410 CT Practitioner - Clinical Social Worker 5991199770 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Centers Inc Clinical CurrentSince Jan 1, 2022 Accepting new patients
Palabra Counseling & Training Center LLC CurrentSince Jul 1, 2024 Accepting new patients
Family Centers Inc CurrentSince Jan 1, 2022 Accepting new patients

Locations

590 Post Rd
Darien, CT 06820
Phone (203) 655-0547

20 Bridge St
Greenwich, CT 06830
Phone (203) 629-2822

530 Middlebury Rd
Ste 206B
Middlebury, CT 06762
Phone (203) 560-7640

986 Bedford St
Stamford, CT 06905
Phone (203) 324-3167

60 Palmers Hill Rd
Stamford, CT 06902
Phone (203) 324-3167

Organizations & group practices 3

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1801454962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 STRAWBERRY HILL AVE APT 418",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022719",
            "telephone_number": "516-776-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PALMERS HILL RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022113",
            "telephone_number": "203-324-3167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Glen View Ter",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065151417",
            "country_code": "US",
            "telephone_number": "203-770-4338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISNIESKI",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.