Active NPI
Danielle N Mastriano, MSW,BA,LMSW,LADC
- Addiction (Substance Use Disorder) Counselor
- Waterbury, CT
National Provider Identifier
1346590601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1124
- Practice address
- 141 E Main St
3Rd Floor Home Based Services
Waterbury, CT 06702-2310 - Phone
- (203) 575-0466
- Fax
- (203) 574-3315
- NPI assigned
- Sep 13, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 000078 | CT | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1124 | CT | Primary |
Addresses
Primary practice location
141 E Main St
3Rd Floor Home Based Services
Waterbury, CT 06702-2310
Mailing address
141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008057354 | Medicaid | CT | |
| 12801295 | Other | CAQH | |
| CAC-6076 | Other | CT | CONNECTICUT CERTIFICATION BOARD, INC |
| ICADC-6076 | Other | CT | CONNECTICUT CERTIFICATION BOARD, INC. |
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)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000078 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1346590601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"address_2": "4TH FLOOR ADMINISTRATION",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-574-9000",
"fax_number": "203-574-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"address_2": "3RD FLOOR HOME BASED SERVICES",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0466",
"fax_number": "203-574-3315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTRIANO",
"first_name": "DANIELLE",
"middle_name": "N",
"credential": "MSW,BA,LMSW,LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-13",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "000078",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "1124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008057354",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12801295",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICUT CERTIFICATION BOARD, INC",
"identifier": "CAC-6076",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICUT CERTIFICATION BOARD, INC.",
"identifier": "ICADC-6076",
"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 Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.