Individual provider Active NPI

Jeff Epps, LCSW, LADC

  • Clinical Social Worker
  • Meriden, CT
National Provider Identifier
1982113379
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
012813 Issued in CT
Practice address
189 Evergreen LN
Meriden, CT 06450-6805
Phone
(203) 820-1570
NPI assigned
Sep 28, 2017
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1255 CT
Clinical Social Worker 1041C0700X 012813 CT Primary

Addresses

Primary practice location

189 Evergreen LN
Meriden, CT 06450-6805

Mailing address

189 Evergreen LN
Meriden, CT 06450-6805
Phone (203) 820-1570

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
I20230410000357 CT Practitioner - Clinical Social Worker 7315312196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Addiction Medicine, LLCGroup PAC ID 3274758560, 6 clinicians

Practice addresses (Care Compare)

546 Cromwell Ave
Suite 101
Rocky Hill, CT 06067-1898
Phone (860) 757-3874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1255CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Gut LLC PastSince Jul 29, 2024 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, 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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1982113379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 EVERGREEN LN",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506805",
            "telephone_number": "203-820-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 EVERGREEN LN",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506805",
            "telephone_number": "203-820-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPS",
        "first_name": "JEFF",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1255",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.