Individual provider Active NPI

Monica Cyr-Kungu, LCSW

  • Clinical Social Worker
  • West Hartford, CT
National Provider Identifier
1457862633
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
010015 Issued in CT
Practice address
345 N Main St Ste 260
West Hartford, CT 06117-2508
Phone
(203) 816-0091
NPI assigned
Oct 16, 2017
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 010015 CT Primary
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

345 N Main St Ste 260
West Hartford, CT 06117-2508

Mailing address

PO Box 358096
Pittsburgh, PA 15251-5096
Phone (203) 998-6678

Other practice location 1

126 Monroe Tpke Ste 210
Trumbull, CT 06611-1300
Phone (203) 800-3596

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

State licenses

LicenseStateTypeSpecialty
010015CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Springtide Child Development, Inc. CurrentSince Jun 26, 2022 Accepting new patients
Springtide Child Development, Inc CurrentSince Jun 26, 2022 Accepting new patients
Springtide Child Development, Inc. PastSince Jun 26, 2022 Accepting new patients
Cortica Developmental Therapies PA PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1457862633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358096",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152515096",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST STE 260",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172508",
            "telephone_number": "203-816-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Monroe Tpke Ste 210",
            "address_purpose": "LOCATION",
            "city": "Trumbull",
            "state": "CT",
            "postal_code": "066111300",
            "country_code": "US",
            "telephone_number": "203-800-3596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYR-KUNGU",
        "first_name": "MONICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010015",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.