Individual provider Active NPI

Nancy Dagostino, LCSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1235407800
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004933 Issued in CT
Practice address
1389 W Main St
Suite 312
Waterbury, CT 06708-3104
Phone
(203) 233-3366
NPI assigned
Dec 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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 004933 CT Primary

Addresses

Primary practice location

1389 W Main St
Suite 312
Waterbury, CT 06708-3104

Mailing address

387 N Georges Hill Rd
Southbury, CT 06488-4600
Phone (203) 233-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120906000474 CT Practitioner - Clinical Social Worker 8527215011 Practice locations: Waterbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

969 W Main St
Suite 3G
Waterbury, CT 06708-2653
Phone (203) 233-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004933CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Waterbury Hospital Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1235407800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 N GEORGES HILL RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884600",
            "telephone_number": "203-233-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 312",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-233-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGOSTINO",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.