Individual provider Active NPI

Jamelah Theresa Stone, LCSW

  • Clinical Social Worker
  • Branford, CT
National Provider Identifier
1932160967
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006074 Issued in CT
Practice address
119 Montowese St
Branford, CT 06405-3807
Phone
(203) 535-6771
Fax
(888) 550-6771
NPI assigned
Mar 29, 2006
Last updated
May 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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 006074 CT Primary

Addresses

Primary practice location

119 Montowese St
Branford, CT 06405-3807

Mailing address

119 Montowese St
Branford, CT 06405-3807
Phone (203) 535-6771

Other practice location 1

764 E Main Street
Unit B
Branford, CT 06405-2929
Phone (203) 535-6771

Other identifiers 4

IdentifierTypeStateIssuer
006074OtherCTCT STATE LICENSE
0080492591MedicaidCT
140006074CT01OtherCTANTHEM
11707579OtherCAQH

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
I20060419000568 CT Practitioner - Clinical Social Worker 1850300823 Practice locations: Branford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

119 Montowese St
Branford, CT 06405-3807
Phone (203) 535-6771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006074CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive and Renew Counseling LLC Clinical Current Accepting new patients
Pathways Associates LLC Clinical PastSince Mar 18, 2012 Accepting new patients
3 Stones Healing Group LLC Clinical Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1932160967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MONTOWESE ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053807",
            "telephone_number": "203-535-6771",
            "fax_number": "888-550-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MONTOWESE ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053807",
            "telephone_number": "203-535-6771",
            "fax_number": "888-550-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "764 E Main Street",
            "address_2": "Unit B",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064052929",
            "country_code": "US",
            "telephone_number": "203-535-6771",
            "fax_number": "888-550-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "JAMELAH",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT STATE LICENSE",
            "identifier": "006074",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080492591",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "140006074CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11707579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.