Individual provider Active NPI

Jannese Lauren Webber, LCSW, LADC

  • Clinical Social Worker
  • Middlebury, CT
National Provider Identifier
1811260599
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009193 Issued in CT
Practice address
20 Woodside Ave Ste a
Middlebury, CT 06762-2857
Phone
(203) 747-8708
Fax
(203) 747-8708
NPI assigned
Feb 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1078 CT
Clinical Social Worker 1041C0700X C015580 NC
Clinical Social Worker 1041C0700X 009193 CT Primary

Addresses

Primary practice location

20 Woodside Ave Ste a
Middlebury, CT 06762-2857

Mailing address

3608 Wood Duck CT NW
Concord, NC 28027-6589
Phone (203) 747-8708

Other practice location 1

2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068
Phone (203) 747-8708

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
I20160107001079 CT Practitioner - Clinical Social Worker 0941502991 Practice locations: Waterbury, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1078CTMDAddiction (Substance Use Disorder) Counselor
009193CTMDClinical Social Worker
C015580NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Talk Time Therapy LLC Clinical Current Accepting new patients

Locations

20 Woodside Ave
Ste A
Middlebury, CT 06762
Phone (203) 721-8108

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": "1328918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1811260599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 WOOD DUCK CT NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280276589",
            "telephone_number": "203-747-8708",
            "fax_number": "203-747-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WOODSIDE AVE STE A",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622857",
            "telephone_number": "203-747-8708",
            "fax_number": "203-747-8708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Ayrsley Town Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282734068",
            "country_code": "US",
            "telephone_number": "203-747-8708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "JANNESE",
        "middle_name": "LAUREN",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-11",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1078",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015580",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

Verify at the official NPI Registry.