Individual provider Active NPI

Stephanie Jane Brown, LCSW

  • Clinical Social Worker
  • Bristol, CT
National Provider Identifier
1922343003
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9233 Issued in CT
Practice address
551 Peacedale St
Bristol, CT 06010-8939
Phone
(860) 212-8442
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 001423 CT
Clinical Social Worker 1041C0700X 9233 CT Primary

Addresses

Primary practice location

551 Peacedale St
Bristol, CT 06010-8939

Mailing address

36 Rosemont Ave
Bristol, CT 06010-7216
Phone (860) 212-8442

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
I20220527000127 CT Practitioner - Clinical Social Worker 3577941871 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001423CTMDSocial Worker
9233CTMDAcute Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: stephanie.brown.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 1

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": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1922343003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ROSEMONT AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107216",
            "telephone_number": "860-212-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 PEACEDALE ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108939",
            "telephone_number": "860-212-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STEPHANIE",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "001423",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.