Evan Alden Leclair, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58.010209 Issued in CT

Practice address

16 Hillside Ave
Naugatuck, CT 06770-4019

Phone

(774) 406-4924

NPI assigned

Aug 31, 2018

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Apple Valley Behavioral Health LLC

  • Professional Counselor
  • Plantsville, CT
  • NPI 1568843456
  Medicare reassignment NPD
• Stokes Counseling Services LLC

  • Professional Counselor
  • Naugatuck, CT
  • NPI 1134541469

  Clinical

  Medicare reassignment NPD
• Sycamore Counseling Services LLC

  • Clinical Social Worker
  • Seymour, CT
  • NPI 1164214748
  Medicare reassignment NPD

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544832000000",
    "number": "1841772324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 KNOLLWOOD DR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922997",
            "telephone_number": "203-443-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HILLSIDE AVE",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704019",
            "telephone_number": "774-406-4924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "174 Knollwood Dr",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "064922997",
            "country_code": "US",
            "telephone_number": "203-443-7842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LECLAIR",
        "first_name": "EVAN",
        "middle_name": "ALDEN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.010209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelcie Kraeer
• Kevin Kuzma, RPT
• Suzanne Lynn Labranche, LPC, LADC, CAC, NCC
• Las Multi Media Productions LLC
• Andrea A Leach
• Amanda Lee
• Long River Physicians, LLC
• Frank K Longo, M.D.
• Yayla Lopez
• Kathryn Anne Loughlin, LCSW

• Clinical Social Worker in Naugatuck, CT
• Providers in Naugatuck, 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 Dec 15, 2018; 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.