Individual provider Active NPI

Jamie Moore-Torres, LCSW

  • Clinical Social Worker
  • Avon, CT
National Provider Identifier
1912396078
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008885 Issued in CT
Practice address
21 Waterville Rd
Avon, CT 06001-2097
Phone
(860) 284-0182
Fax
(860) 284-6804
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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 008885 CT Primary

Addresses

Primary practice location

21 Waterville Rd
Avon, CT 06001-2097

Mailing address

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

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
I20150217001779 CT Practitioner - Clinical Social Worker 0941525810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008885CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Sep 1, 2025 Accepting new patients
State of Connecticut CurrentSince Sep 1, 2025 Accepting new patients

Locations

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1912396078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-284-0182",
            "fax_number": "860-284-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERVILLE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012097",
            "telephone_number": "860-284-0182",
            "fax_number": "860-284-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-TORRES",
        "first_name": "JAMIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.