Organization Active NPI

Dagmara Niecikowski, LLC

  • Clinical Social Worker
  • New Britain, CT
National Provider Identifier
1255896064
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DAGMARA NIECIKOWSKI, LLC
Practice address
45 Russell St
New Britain, CT 06052-1312
Phone
(860) 348-3371
Fax
(860) 612-0087
NPI assigned
Feb 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Dagmara Niecikowski, LCSWNPI 1972821536
Title
LCSW
Phone
(860) 348-3371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

45 Russell St
New Britain, CT 06052-1312

Mailing address

33 Renn LN
Berlin, CT 06037-3589
Phone (860) 748-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200821001235 CT Part B Supplier - Clinic/Group Practice 0648696567 Receives reassigned benefits from 1 practitioner
Practice locations: New Britain, CT

National Provider Directory

National Provider Directory

Locations

45 Russell St
New Britain, CT 06052
Phone (860) 348-3371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1255896064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 RENN LN",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060373589",
            "telephone_number": "860-748-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RUSSELL ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521312",
            "telephone_number": "860-348-3371",
            "fax_number": "860-612-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAGMARA NIECIKOWSKI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "NIECIKOWSKI",
        "authorized_official_first_name": "DAGMARA",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "860-348-3371",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.