MIRA MCDERMOTT (M.A.) – Social Worker, NPI 1124400916

MIRA MCDERMOTT (M.A.) is a healthcare provider. based in Bristol, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials M.A.. The NPI Number for MIRA MCDERMOTT (M.A.) is 1124400916

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
MIRA MCDERMOTT (M.A.)
NPI
1124400916
Phone
(860) 584-6555
Address
10 N MAIN ST
Enumeration Date
29 June 2015
Last Update Date
29 June 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8607933500
Graduation Year
2016 (10 years ago)
PAC ID
2567711625
Group Practice PAC ID
0345147153
Professional Enrollment ID
I20180822002251
Address ID
CT061052363HA43XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:10State licenses:0Digital endpointsOther names

2,151 CLINICAL SOCIAL WORKER in CT

Provider Addresses for MIRA MCDERMOTT (M.A.)

  • 10 N MAIN ST

    BRISTOL, CT 060108122

    Phone: (860) 584-6555

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2018-08-22

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
I20180822002251IClinical 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 06010)

Loading plans...

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: 0345147153View full group profile
NameSpecialtyState
Clinical Social WorkerCT
Family PracticeCT
Mental Health CounselorCT
Clinical Social WorkerCT
Clinical Social WorkerCT
Clinical Social WorkerCT
Family PracticeCT
Clinical Social WorkerCT
Nurse PractitionerCT
Clinical Social WorkerCT

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What number should I use to identify MIRA MCDERMOTT (M.A.) for billing?
Administrative and clinical systems typically use NPI 1124400916 for MIRA MCDERMOTT (M.A.).
Quick check: is MIRA MCDERMOTT (M.A.) active?
Public NPPES data shows MIRA MCDERMOTT (M.A.) with an active NPI status right now.
How should patients interpret MIRA MCDERMOTT (M.A.)'s specialty?
The extract shows Social Worker for MIRA MCDERMOTT (M.A.). Clinical services aligned with this taxonomy classification.
Is MIRA MCDERMOTT (M.A.) tied to Bristol, Connecticut?
If you are local to Bristol, Connecticut, MIRA MCDERMOTT (M.A.) may be relevant to your search.
Can I export MIRA MCDERMOTT (M.A.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

DOREEN E BUTTNER (LCSW)

Clinical Social Worker
Bristol Post Office, Crumley Alley, Bristol, Sullivan County, East Tennessee, Tennessee, 24201, United States
NPI: 1295710374
Bristol Post Office, Crumley Alley, Bristol, Sullivan County, East Tennessee, Tennessee, 24201, United States
NPI: 1285619346
501 S WASHINGTON AVE STE 1000
NPI: 1609851633

AUDREY L BENNETT (LCSW, LADC)

Clinical Social Worker
95-1184 Makaikai St Apt 55
NPI: 1093824294

KELLY ANNE MANGIAFICO (LCSW)

Clinical Social Worker
175 PHILPOTT LN
NPI: 1538218805
11, Boulder Ridge, Southington, Capitol Planning Region, Connecticut, 06489, United States
NPI: 1104975937
57, Genovese Drive, Forestville, Bristol, Naugatuck Valley Planning Region, Connecticut, 06010, United States
NPI: 1457401242
PO BOX 1280
NPI: 1457571945
440, North Main Street, Attleboro, Bristol County, Massachusetts, 02703, United States
NPI: 1740402908