Individual provider Active NPI

Jill Wendy Chaus Carnes, MS, LCSW

  • Clinical Social Worker
  • Brookfield, CT
National Provider Identifier
1861143067
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005259 Issued in CT
Practice address
31 Old Route 7
Brookfield, CT 06804-1711
Phone
(203) 775-2583
NPI assigned
Jan 10, 2022
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 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 005259 CT Primary

Addresses

Primary practice location

31 Old Route 7
Brookfield, CT 06804-1711

Mailing address

31 Old Route 7
Brookfield, CT 06804-1711

Other practice location 1

429 Candlewood Lake Rd N
New Milford, CT 06776-4105
Phone (203) 313-1480

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
I20220120001070 CT Practitioner - Clinical Social Worker 0042602229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005259CTMDClinical Social Worker
5259CTMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1861143067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ROUTE 7",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041711",
            "telephone_number": "203-775-2583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Candlewood Lake Rd N",
            "address_purpose": "LOCATION",
            "city": "New Milford",
            "state": "CT",
            "postal_code": "067764105",
            "country_code": "US",
            "telephone_number": "203-313-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUS CARNES",
        "first_name": "JILL",
        "middle_name": "WENDY",
        "credential": "MS, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2024-10-04",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.