DESERIE ALINE CLACK-WILSON (NPI# 1447869029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447869029 |
| Entity Type | Individual |
| Full Name | DESERIE ALINE CLACK-WILSON |
| Practice Address |
1000 Lafayette Blvd Ste 1128 Bridgeport CT 06604-4725 |
| Practice Telephone | 2036833428 |
| Practice Fax Number | 2036835901 |
| Mailing Telephone | 2036833428 |
| Mailing Fax Number | 2036835901 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172V00000X | Community Health Worker | CT | Other Service Providers |
| Street Address |
1000 LAFAYETTE BLVD STE 1128 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06604-4725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
| 1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
| 1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
| 1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
| 1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
| 1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| Find all providers in zip 06604 | ||||
| Taxonomy Code | 172V00000X |
| Grouping | Other Service Providers |
| Classification | Community Health Worker |
| Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC §1616 (l) under HHS, Indian Health Service, Public Health Service. |
| Notes: Source: Health Resources and Services Administration, US Department of Health and Human Services – National Workforce Study on Community Health Workers, March, 2007. [7/1/2007: new] http://bhpr.hrsa.gov/healthworkforce/chw/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043626997 | Jerome C Hailey | Community Health Worker | 215 Daniels Ave, Bridgeport, CT 06606-1513 | 2014-07-10 |
| 1215162425 | Kim Mims | Community Health Worker | 865 Laurel Ave, Bridgeport, CT 06604-2406 | 2009-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679194245 | Nicole S Barstow | Community Health Worker | 49 Day St Apt 213, Norwalk, CT 06854-4903 | 2020-05-05 |
| 1881232767 | W & J Homecare | Community Health Worker | 847 W Main St Ste 2r, Branford, CT 06405-3456 | 2019-12-11 |
| 1003313065 | Brandon Lamar Holley | Community Health Worker | 76 Phelps St, East Hartford, CT 06108-2259 | 2018-04-06 |
| 1548708951 | Alyssa Marchese | Community Health Worker | 66 Ring St, Putnam, CT 06260-2116 | 2017-02-06 |
| 1124564646 | Linda B Lemnotis | Community Health Worker | 228 West St, Plantsville, CT 06479-1145 | 2017-01-08 |
| 1306393947 | Eric Washington | Community Health Worker | 34 Spindle Hill Road, Wellmore Inc Valiant House, Wolcott, CT 06716-1732 | 2016-09-01 |
| 1336529445 | Amy Kathryn Damato | Community Health Worker | 19 Saddle Hill Cir, Newington, CT 06111-1826 | 2015-06-03 |
| 1003203985 | Sascha Ilana Van Creveld | Community Health Worker | 345 Stevenson Rd, New Haven, CT 06515-2470 | 2015-04-19 |
| 1356734206 | Naida R Rosado | Community Health Worker | 188 Faber Ave, Waterbury, CT 06704-1832 | 2015-03-16 |
| 1477943298 | Amanda Potter | Community Health Worker | 16 Old Barn Rd, East Windsor, CT 06088-1726 | 2015-02-01 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 06604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.