Eric Brenner Fabricant, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008409 Issued in CT

Practice address

2911 Dixwell Ave Ste 202B
Hamden, CT 06518-3130

Phone

(203) 605-2057

Fax

(203) 651-1462

NPI assigned

Feb 10, 2011

Last updated

Apr 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Health and Wellness Solutions of CT LLCGroup PAC ID 5395020945, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Health and Wellness Solutions of CT, LLC

  • Clinical Social Worker
  • Hamden, CT
  • NPI 1114479888
  Medicare reassignment Care Compare group NPD
• Connecticut Psychiatric & Wellness Center

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbridge, CT
  • NPI 1528326808
  Medicare reassignment NPD
• Connecticut Psychiatric & Wellness Center

  • Community/Behavioral Health Agency
  • Woodbridge, CT
  • NPI 1174902084
  NPD (past)
• Pathways Center for Learning & Behavioral Health, LLC

  • Marriage & Family Therapist
  • Essex, CT
  • NPI 1467760595

  Clinical

  NPD (past)

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1922304849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 DIXWELL AVE STE 202B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183130",
            "telephone_number": "203-605-2057",
            "fax_number": "203-651-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 DIXWELL AVE STE 202B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183130",
            "telephone_number": "203-605-2057",
            "fax_number": "203-651-1462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 Westbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Essex",
            "state": "CT",
            "postal_code": "064261528",
            "country_code": "US",
            "telephone_number": "860-767-1277 x201",
            "fax_number": "860-767-7712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FABRICANT",
        "first_name": "ERIC",
        "middle_name": "BRENNER",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-10",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Center of Southern Connecticut, PC
• Eye Center of Southern Connecticut, PC
• Eye Center of Southern Connectucut, PC
• Wilma Joan Ezekowitz, PH.D
• Chinyere Ezigbo
• Families Home Care,LLC
• Family & Esthetic Dentistry of Hamden LLC
• Family and Internal Medicine of Dixwell Avenue
• Family Chiropractic and Wellness, LLC
• Family First Counseling and Addiction Services LLC

• Clinical Social Worker in Hamden, CT
• Providers in Hamden, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.