Active NPI
Daisy Santiago-Levasseur, LCSW
- Clinical Social Worker
- Waterbury, CT
National Provider Identifier
1194021758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 007062
- Practice address
- 95 Thomaston Ave
Waterbury, CT 06702-1007 - Phone
- (203) 805-5300
- Fax
- (203) 805-5310
- NPI assigned
- Jan 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007062 | CT | Primary |
Addresses
Primary practice location
95 Thomaston Ave
Waterbury, CT 06702-1007
Mailing address
95 Thomaston Ave
Waterbury, CT 06702-1007
Phone (203) 805-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C02788 | Other | CT | MEDICARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007062 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1194021758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 THOMASTON AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021007",
"telephone_number": "203-805-5300",
"fax_number": "203-805-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 THOMASTON AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021007",
"telephone_number": "203-805-5300",
"fax_number": "203-805-5310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO-LEVASSEUR",
"first_name": "DAISY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "007062",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "C02788",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.