Maribel Agosto, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11190 Issued in CT

Practice address

1130 Cutspring Rd
Stratford, CT 06614-1957

Phone

(203) 914-3004

NPI assigned

May 12, 2021

Last updated

May 12, 2021By 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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State of Connecticut

  dba Southwest Connecticut Mental Health System

  • Psychiatric Hospital
  • Bridgeport, CT
  • NPI 1720013360
  Medicare reassignment NPD
• State of Connecticut

  dba Department of Veterans' Affairs, Veterans Home

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1831773084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 CUTSPRING RD",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141957",
            "telephone_number": "203-914-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTO",
        "first_name": "MARIBEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kwame Acheampong, NP
• Adedoyin Adebogun, PHARMD
• Advanced Dental Sleep Medicine of Connecticut, PC
• Advanced Psychotherapy Practice LLC
• Agewell Rehab Services PLLC
• Idaira Aguilar Tejedor, M.D.
• Maria Aguirre
• Daune Alexis-Bailey
• Nada Y Alsaigh, M.D.
• James Burns Amberson, M.D.

• Clinical Social Worker in Stratford, CT
• Providers in Stratford, 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 May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.