Active NPI
Nancy Ellen McDermott
- Clinical Social Worker
- Fairfield, CT
National Provider Identifier
1811602733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 010576
- Practice address
- 74 Cedar Woods LN
Fairfield, CT 06825-1308 - Phone
- (718) 809-3421
- NPI assigned
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 010576 | CT | Primary |
Addresses
Primary practice location
74 Cedar Woods LN
Fairfield, CT 06825-1308
Mailing address
74 Cedar Woods LN
Fairfield, CT 06825-1308
Phone (718) 809-3421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010576 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1811602733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 CEDAR WOODS LN",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251308",
"telephone_number": "718-809-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 CEDAR WOODS LN",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068251308",
"telephone_number": "718-809-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "NANCY",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "010576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.