Individual provider Active NPI

Stephanie Encarnacion, LCSW

  • Clinical Social Worker
  • West Haven, CT
National Provider Identifier
1861167611
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11641 Issued in CT
Practice address
415 Main St
West Haven, CT 06516-4296
Phone
(203) 931-1184
NPI assigned
Aug 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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 11641 CT Primary

Addresses

Primary practice location

415 Main St
West Haven, CT 06516-4296

Mailing address

415 Main St
West Haven, CT 06516-4296
Phone (203) 931-1184

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
I20210922001751 CT Practitioner - Clinical Social Worker 6800293564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shoreline Wellness Behavioral Health Outreach IncGroup PAC ID 1951796119, 16 clinicians

Practice addresses (Care Compare)

415 Main St
West Haven, CT 06516-4296
Phone (203) 931-1184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11641CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Wellness Center, LLC. Clinical CurrentSince Aug 11, 2021 Accepting new patients
Shoreline Wellness Behavioral Health Outreach Inc CurrentSince Jul 30, 2022 Accepting new patients

Locations

415 Main St
Lowr
West Haven, CT 06516

415 Main St
West Haven, CT 06516
Phone (203) 931-1184

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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1861167611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-931-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-931-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENCARNACION",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.