Individual provider Active NPI

Donald F Degraffenried, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1104095298
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005398 Issued in CT
Practice address
660 Winchester Ave
New Haven, CT 06511-1969
Phone
(203) 776-8390
NPI assigned
Feb 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 005398 CT Primary

Addresses

Primary practice location

660 Winchester Ave
New Haven, CT 06511-1969

Mailing address

660 Winchester Ave
New Haven, CT 06511-1969
Phone (203) 776-8390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
005398CTMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1104095298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WINCHESTER AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111969",
            "telephone_number": "203-776-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 WINCHESTER AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111969",
            "telephone_number": "203-776-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAFFENRIED",
        "first_name": "DONALD",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.