Jennifer Fairchild, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006449 Issued in CT

Practice address

183 Elizabeth St
Derby, CT 06418-1813

Phone

(203) 929-2093

Fax

(203) 929-2093

NPI assigned

Sep 4, 2007

Last updated

Sep 4, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Christian Counseling and Family Life Center, Inc.

  • Marriage & Family Therapist
  • Shelton, CT
  • NPI 1740313568

  Clinical

  NPD (past)
• The Motivation Center of Stratford, Inc.

  • Psychologist
  • Shelton, CT
  • NPI 1124101696
  NPD (past)

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1821282880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUNDVIEW AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064842744",
            "telephone_number": "203-929-2093",
            "fax_number": "203-929-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 ELIZABETH ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181813",
            "telephone_number": "203-929-2093",
            "fax_number": "203-929-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Elkeik, MD
• Engagerentals
• Christina Ernst, MS,RD,CDN
• Victoria Espiritusanto-Diaz
• Golfam Fadaei, MD
• Julie Falcone, LCSW
• Family Dentistry of Derby P.C
• Alexandra Farley, MSW
• Cecilia Marie Fernandes, RDH
• Gerald George Fette, M.D.

• Clinical Social Worker in Derby, CT
• Providers in Derby, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.