Individual provider Active NPI

Estephany Meliza Valerio-Negron, LCSW

  • Clinical Social Worker
  • Fairfield, CT
National Provider Identifier
1881025435
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
011301 Issued in CT
Practice address
1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone
(203) 384-8681
Fax
(203) 384-0722
NPI assigned
Dec 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 090890 NY
Clinical Social Worker 1041C0700X 085406 NY
Clinical Social Worker 1041C0700X 011301 CT Primary

Addresses

Primary practice location

1931 Black Rock Tpke
Fairfield, CT 06825-3506

Mailing address

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

Other identifiers 1

IdentifierTypeStateIssuer
04015472MedicaidNY

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
I20211221002432 CT Practitioner - Clinical Social Worker 7719264399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 332-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085406NYMDSocial Worker
090890NYMDSocial Worker
011301CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Care Counseling LLC CurrentSince Nov 1, 2021 Accepting new patients
South-West Community Health Center, Inc CurrentSince Jun 29, 2022 Accepting new patients

Locations

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

1046 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 330-6054

984 Southford Rd
Middlebury, CT 06762
Phone (203) 758-2400

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": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1881025435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253506",
            "telephone_number": "203-384-8681",
            "fax_number": "203-384-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253506",
            "telephone_number": "203-384-8681",
            "fax_number": "203-384-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERIO-NEGRON",
        "first_name": "ESTEPHANY",
        "middle_name": "MELIZA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2023-11-02",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090890",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085406",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015472",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.