MELISSA ABLES WILSON JACOB (NPI# 1992767347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992767347 |
| Entity Type | Individual |
| Full Name | MELISSA ABLES WILSON JACOB |
| Credential | L.C.S.W |
| Practice Address |
1129 Essex Pl Stratford CT 06615-5850 |
| Practice Telephone | 2033758140 |
| Practice Fax Number | 2033758050 |
| Mailing Telephone | 2033758140 |
| Mailing Fax Number | 2033758050 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2009-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
005167 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004247096 | 05 | |
| CT | ANTHEM | 140005167CT02 | 01 |
| CT | MHN | 279269 | 01 |
| Street Address |
1129 ESSEX PL |
| City | STRATFORD |
| State | CT |
| Zip Code | 06615-5850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881655751 | David G Jacob | Social Worker | 1129 Essex Pl, Stratford, CT 06615-5850 | 2006-03-30 |
| 1548738362 | Grace M Thomas Lpc LLC | Community/Behavioral Health | 1129 Essex Pl, Stratford, CT 06615-5867 | 2018-11-09 |
| 1114207289 | Kathleen Carius, Aprn | Registered Nurse | 1129 Essex Pl, Stratford, CT 06615-5867 | 2011-08-22 |
| 1821376591 | Kathleen P. Carius Aprn, LLC | Nurse Practitioner | 1129 Essex Pl, Stratford, CT 06615-5867 | 2011-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154713832 | Lauren Pessin | Behavioral Analyst | 55 Sutton Ave, Stratford, CT 06615 | 2015-03-04 |
| 1801223748 | Steven Flathers | Occupational Therapist | 27 Eunice Parkway, Stratford, CT 06615 | 2013-10-10 |
| 1700219243 | Stratford Orthodontics | Dentist | 2499 Main Street, Stratford, CT 06615 | 2013-08-20 |
| 1417380981 | Debra L Tomaselli | Marriage & Family Therapist | 2296 Main Street, 2nd Floor, Stratford, CT 06615 | 2013-08-19 |
| 1003199217 | Katherine Bajda | Nurse Practitioner | 837 Prospect Drive, Stratford, CT 06615 | 2011-09-23 |
| 1336326495 | Dammy Bamisile | Social Worker | 100 Center Street, Shelton, CT 06615 | 2008-01-30 |
| 1487868550 | Mark Rabin | Medical Genetics, Ph.D. Medical Genetics | Dianon Systems, 200 Watson Boulevard, Stratford, CT 06615 | 2007-05-09 |
| 1205958675 | Sophia Leonida M.d., PC | Clinic/Center | 2505 Main St., Stratford, CT 06615 | 2007-04-04 |
| 1558488213 | Fatima Eslami-varzaneh | Pathology | 200 Watson Boulvard, Stratford, CT 06615 | 2007-03-26 |
| 1881729804 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 555 Lordship Boulevard, Stratford, CT 06615 | 2007-02-22 |
| Find all providers in zip 06615 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699319152 | Thomas Blackwell, Lcsw, LLC | Social Worker | 2945 Main St Ste A, Stratford, CT 06614-4978 | 2019-10-28 |
| 1205391810 | Cynthia Ann Melendez | Social Worker | 156 Broadmere Rd, Stratford, CT 06614-2505 | 2019-02-07 |
| 1861976987 | Deborah Downes Cahill | Social Worker | 80 Harvest Ridge Rd, Stratford, CT 06614-8933 | 2018-09-25 |
| 1598262941 | Shelly Indrawatti Bheer | Social Worker | 65 Osborne St, Stratford, CT 06614-4326 | 2018-04-11 |
| 1164933834 | Nia Danielle Denard-walker | Social Worker | 647 California St, Stratford, CT 06614-4908 | 2017-10-20 |
| 1356872774 | Theresa Ann Montelli-cavoto | Social Worker | 775 Chickadee Ln, Stratford, CT 06614-2479 | 2017-03-27 |
| 1417328634 | Kelley Machado | Social Worker | 2127 Nichols Ave, Stratford, CT 06614 | 2015-10-14 |
| 1427433580 | Meghan Fox | Social Worker | 100 Anson St, Stratford, CT 06614-2801 | 2015-07-29 |
| 1588044879 | Marie-paule Lopez De Valdivia | Social Worker | 90 Fifth Ave, Stratford, CT 06615-7778 | 2015-06-02 |
| 1962898429 | Alicia Charlotte Simpson | Social Worker | 120 Wainwright Pl, Stratford, CT 06614-3247 | 2015-04-11 |
| Find all providers in STRATFORD | ||||
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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.