DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) – Clinical Social Worker, NPI 1013926708

DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) is a healthcare provider. based in Hamden, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials PSY.D., LCSW. They hold a License No. 000823 (CT). The NPI Number for DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) is 1013926708

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW)
NPI
1013926708
Phone
(203) 287-8227
Address
295 WASHINGTON AVENUE
Enumeration Date
5 August 2006
Last Update Date
14 February 2012

Doctor Profile

Medical School Name
UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Secondary Phone
2032878227
Graduation Year
1978 (48 years ago)
PAC ID
8729083704
Group Practice PAC ID
4284639261
Professional Enrollment ID
I20181206002854
Address ID
CT065183025HA295XXAVEX311
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

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Provider Addresses for DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW)

  • 295, Washington Avenue, Centerville, Hamden, South Central Connecticut Planning Region, Connecticut, 06518, United States

    SUITE 9

    HAMDEN, CT 065183025

    Phone: (203) 287-8227

    Fax: (203) 287-9502

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181206002854IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06518)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284639261View full group profile
NameSpecialtyState
Clinical Social WorkerCT
Clinical PsychologistCT

Reviews

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Frequently asked questions

Does DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) uses 1013926708.
Can I rely on DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) being an active provider?
As of the registry snapshot, DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) is marked active.
What is DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW)'s primary classification?
Clinical Social Worker is the headline specialty for DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) here. Clinical services aligned with this taxonomy classification.
Does DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) list a practice location?
Patients near Hamden, Connecticut may find DR. JEFFREY WARREN SUMMERVILLE (PSY.D., LCSW) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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