DAMARIS RODRIGUEZ (LCSW) – Clinical Social Worker, NPI 1104157254

DAMARIS RODRIGUEZ (LCSW) is a healthcare provider. based in New haven, Connecticut. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. 9488 (CT). The NPI Number for DAMARIS RODRIGUEZ (LCSW) is 1104157254

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
DAMARIS RODRIGUEZ (LCSW)
NPI
1104157254
Phone
(203) 503-3174
Address
428 COLUMBUS AVE
Enumeration Date
28 January 2010
Last Update Date
16 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037777411
Graduation Year
2010 (16 years ago)
PAC ID
4587950753
Group Practice PAC ID
4183511538
Professional Enrollment ID
I20160914001991
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

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Provider Addresses for DAMARIS RODRIGUEZ (LCSW)

  • 428 COLUMBUS AVE

    CREDENTIALING SPECIALIST

    NEW HAVEN, CT 065191233

    Phone: (203) 503-3174

    Fax: (203) 503-3183

    Type: Mailing

  • 400, Columbus Avenue, Hill, New Haven, New Haven County, Connecticut, 06519, United States

    NEW HAVEN, CT 065191233

    Phone: (203) 503-3174

    Fax: (203) 503-3183

    Type: Mailing

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: 2016-09-14

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
I20160914001991IClinical 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 06519)

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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: 4183511538View full group profile
NameSpecialtyState
Nurse PractitionerCT
Clinical Social WorkerCT
-GA
-CT
Nurse PractitionerCT
Family PracticeCT
Family PracticeCT
-CT
Internal Medicine, Geriatric MedicineIL
Marriage And Family TherapistCT

Reviews

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Frequently asked questions

How do I look up DAMARIS RODRIGUEZ (LCSW) by NPI?
Use NPI 1104157254 when you need to reference DAMARIS RODRIGUEZ (LCSW) in forms, claims, or directories.
Is DAMARIS RODRIGUEZ (LCSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DAMARIS RODRIGUEZ (LCSW)?
The page reflects Clinical Social Worker for DAMARIS RODRIGUEZ (LCSW). Clinical services aligned with this taxonomy classification.
Where is DAMARIS RODRIGUEZ (LCSW)'s primary listing?
We display New Haven, Connecticut because that is what the record indicates for DAMARIS RODRIGUEZ (LCSW).
How can I contact DAMARIS RODRIGUEZ (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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400, Columbus Avenue, Hill, New Haven, New Haven County, Connecticut, 06519, United States
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