Individual provider Active NPI

Cynthia Lassiter, LCSW

  • Clinical Social Worker
  • Putnam, CT
National Provider Identifier
1336881218
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11970 Issued in CT
Practice address
202 Pomfret Street
Putnam, CT 06260-1833
Phone
(860) 963-7917
Fax
(860) 963-0015
NPI assigned
Apr 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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 11970 CT Primary

Addresses

Primary practice location

202 Pomfret Street
Putnam, CT 06260-1833

Mailing address

40 Mansfield Avenue
Willimantic, CT 06226-2018
Phone (860) 450-7471

Other practice location 1

22 Bayview Ave # 4G
Stonington, CT 06378-1142
Phone (860) 690-7048

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
I20220527000437 CT Practitioner - Clinical Social Worker 8325426638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

47 Town St
Norwich, CT 06360-2323
Phone (860) 892-7042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11970CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
United Community and Family Services, Inc. CurrentSince Apr 6, 2022 Accepting new patients
Oak Mountain Therapy, LLC PastSince Oct 24, 2021 Accepting new patients

Locations

70 Main St
Jewett City, CT 06351
Phone (860) 376-7040

47 Town St
Norwich, CT 06360

Organizations & group practices 2

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1336881218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVENUE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET STREET",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917",
            "fax_number": "860-963-0015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bayview Ave # 4G",
            "address_purpose": "LOCATION",
            "city": "Stonington",
            "state": "CT",
            "postal_code": "063781142",
            "country_code": "US",
            "telephone_number": "860-690-7048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.