Individual provider Active NPI

Brooke Corinne Vargas, LCSW

  • Clinical Social Worker
  • Stratford, CT
National Provider Identifier
1851626584
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
009296 Issued in CT
Practice address
2900 Main St Ste 3DF
Stratford, CT 06614-4946
Phone
(203) 321-3238
Fax
(203) 307-0821
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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 009296 CT Primary

Addresses

Primary practice location

2900 Main St Ste 3DF
Stratford, CT 06614-4946

Mailing address

2900 Main St Ste 3DF
Stratford, CT 06614-4946
Phone (203) 321-3238

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
I20170619002510 CT Practitioner - Clinical Social Worker 1951679786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2900 Main St
Suite 3DF
Stratford, CT 06614-4946
Phone (203) 321-3238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009296CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clearsource Counseling, PLLC Clinical CurrentSince Oct 1, 2022 Accepting new patients

Locations

60 Katona Dr
Ste 16
Fairfield, CT 06824
Phone (203) 457-3963

2900 Main St
Ste 3DF
Stratford, CT 06614
Phone (203) 321-3238

Organizations & group practices 2

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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1851626584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MAIN ST STE 3DF",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144946",
            "telephone_number": "203-321-3238",
            "fax_number": "203-307-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MAIN ST STE 3DF",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144946",
            "telephone_number": "203-321-3238",
            "fax_number": "203-307-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "BROOKE",
        "middle_name": "CORINNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.