Individual provider Active NPI

Jenifer Lynn Heseltine, LCSW

  • Clinical Social Worker
  • Cheshire, CT
National Provider Identifier
1831840735
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
011842 Issued in CT
Practice address
290 Highland Ave Ste 2
Cheshire, CT 06410-2564
Phone
(203) 250-7400
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 011842 CT Primary

Addresses

Primary practice location

290 Highland Ave Ste 2
Cheshire, CT 06410-2564

Mailing address

290 Highland Ave Ste 2
Cheshire, CT 06410-2564
Phone (203) 250-7400

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
I20260512004509 CT Practitioner - Clinical Social Worker 7416426093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

274 Madison Ave
RM 1501
New York, NY 10016-0720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011842CTMDClinical Social Worker

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": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1831840735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 HIGHLAND AVE STE 2",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102564",
            "telephone_number": "203-250-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 HIGHLAND AVE STE 2",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102564",
            "telephone_number": "203-250-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESELTINE",
        "first_name": "JENIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.