KENYATTA TOLBERT (LCSW) – Clinical Social Worker, NPI 1497223887

KENYATTA TOLBERT (LCSW) is a healthcare provider. based in Bridgeport, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 10415 (CT). The NPI Number for KENYATTA TOLBERT (LCSW) is 1497223887

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KENYATTA TOLBERT (LCSW)
NPI
1497223887
Phone
(203) 368-4291
Address
475 CLINTON AVE
Enumeration Date
5 November 2018
Last Update Date
5 November 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2038662541
Graduation Year
2016 (10 years ago)
PAC ID
3375887292
Group Practice PAC ID
0941253728
Professional Enrollment ID
I20181204002461
Address ID
CT068503309NO4XXXXPLXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

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Provider Addresses for KENYATTA TOLBERT (LCSW)

  • 475, Clinton Avenue, Bridgeport, Fairfield County, Connecticut, 06605, United States

    BRIDGEPORT, CT 066051700

    Phone: (203) 368-4291

    Fax: (203) 368-9167

    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: 2018-12-04

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
I20181204002461IClinical 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 06605)

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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: 0941253728View full group profile
NameSpecialtyState
P S Y C H I A T R YCT
Marriage And Family TherapistCT
Clinical Social WorkerCT
Nurse PractitionerCT
Marriage And Family TherapistCT
Mental Health CounselorCT

Reviews

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Frequently asked questions

Can I verify KENYATTA TOLBERT (LCSW) with an NPI only?
You can start verification with NPI 1497223887 for KENYATTA TOLBERT (LCSW), then check state licensing separately.
Does the file indicate KENYATTA TOLBERT (LCSW) is practicing under active NPI?
Directory data currently reports KENYATTA TOLBERT (LCSW) as active.
What is KENYATTA TOLBERT (LCSW)'s specialty?
The listing groups KENYATTA TOLBERT (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is KENYATTA TOLBERT (LCSW) based?
KENYATTA TOLBERT (LCSW) is tied to Bridgeport, Connecticut in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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