Individual provider Active NPI

Therese Alexander-Ssebagala, LCSW

  • Clinical Social Worker
  • Groton, CT
National Provider Identifier
1952836660
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
554 Long Hill Rd Ste 8
Groton, CT 06340-4170
Phone
(860) 650-0053
Fax
(508) 433-1871
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 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 Primary

Addresses

Primary practice location

554 Long Hill Rd Ste 8
Groton, CT 06340-4170

Mailing address

21 Providence CT
Groton, CT 06340-4711
Phone (860) 650-0053

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
I20220426003007 CT Practitioner - Clinical Social Worker 7719374545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

554 Long Hill Rd
Suite 8
Groton, CT 06340-4170
Phone (860) 650-0053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Potential Counseling, Inc. Clinical CurrentSince Jan 2, 2022 Accepting new patients

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1952836660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PROVIDENCE CT",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404711",
            "telephone_number": "860-650-0053",
            "fax_number": "508-433-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LONG HILL RD STE 8",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404170",
            "telephone_number": "860-650-0053",
            "fax_number": "508-433-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER-SSEBAGALA",
        "first_name": "THERESE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.