HEATHER LYN ROSENBAUM (LCSW) – Clinical Social Worker, NPI 1356085765

HEATHER LYN ROSENBAUM (LCSW) is a healthcare provider. based in Southport, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 010177 (CT). The NPI Number for HEATHER LYN ROSENBAUM (LCSW) is 1356085765

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER LYN ROSENBAUM (LCSW)
NPI
1356085765
Phone
(203) 640-0777
Address
201 HULLS HWY
Enumeration Date
21 April 2022
Last Update Date
21 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2039291117
Graduation Year
2015 (11 years ago)
PAC ID
4082092606
Group Practice PAC ID
4688637010
Professional Enrollment ID
I20220609000995
Address ID
CT064843323SH183XXAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

Provider Addresses for HEATHER LYN ROSENBAUM (LCSW)

  • 201 HULLS HWY

    SOUTHPORT, CT 068901183

    Phone: (203) 640-0777

    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: 2022-06-09

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
I20220609000995IClinical 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 06890)

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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: 4688637010View full group profile
NameSpecialtyState
Nurse PractitionerCT
-CT
P S Y C H I A T R YCT
-CT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Clinical Social WorkerCT
Marriage And Family TherapistCT
Marriage And Family TherapistCT
Nurse PractitionerCT

Reviews

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Frequently asked questions

Can I verify HEATHER LYN ROSENBAUM (LCSW) with an NPI only?
You can start verification with NPI 1356085765 for HEATHER LYN ROSENBAUM (LCSW), then check state licensing separately.
Does CMS list HEATHER LYN ROSENBAUM (LCSW) as active?
Yes — HEATHER LYN ROSENBAUM (LCSW) is active in the NPI listing used on this page.
What healthcare role does HEATHER LYN ROSENBAUM (LCSW) hold?
Scheduling teams often label HEATHER LYN ROSENBAUM (LCSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect HEATHER LYN ROSENBAUM (LCSW) on a map?
Expect Southport, Connecticut as a primary anchor for HEATHER LYN ROSENBAUM (LCSW) unless the record lists multiple sites.
Is the information about HEATHER LYN ROSENBAUM (LCSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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