Individual provider Active NPI

Vanessa Santiago, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1992878896
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5690 Issued in CT
Practice address
400 Columbus Avenue
Child& Family Guidance
Newhaven, CT 06519-1233
Phone
(203) 503-3055
Fax
(203) 503-3466
NPI assigned
Nov 16, 2006
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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 5690 CT Primary

Addresses

Primary practice location

400 Columbus Avenue
Child& Family Guidance
Newhaven, CT 06519-1233

Mailing address

400 Columbus Ave
Credentialing
New Haven, CT 06519-1233
Phone (203) 503-3000

Other practice location 1

16 Cedar St
New Haven, CT 06519-2315
Phone (203) 887-0039

Other identifiers 1

IdentifierTypeStateIssuer
008035759MedicaidCT

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
I20060109000470 CT Practitioner - Clinical Social Worker 4183647852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5690CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
VS Bilingual Counseling Services Clinical Current 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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1992878896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "address_2": "CREDENTIALING",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CHILD& FAMILY GUIDANCE",
            "city": "NEWHAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3055",
            "fax_number": "203-503-3466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Cedar St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065192315",
            "country_code": "US",
            "telephone_number": "203-887-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "VANESSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "5690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008035759",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.