Individual provider Active NPI

Daphne E Donahue, LCSW

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1538120332
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004663 Issued in CT
Practice address
770 Saybrook Rd BLDG B
Middletown, CT 06457-4739
Phone
(860) 227-5962
NPI assigned
Mar 31, 2006
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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 004663 CT Primary

Addresses

Primary practice location

770 Saybrook Rd BLDG B
Middletown, CT 06457-4739

Mailing address

83 Springbrook Dr
Rocky Hill, CT 06067-3623
Phone (860) 227-5962

Other practice location 1

1177 Silas Deane Hwy
Wethersfield, CT 06109-4348
Phone (860) 227-5962

Other identifiers 1

IdentifierTypeStateIssuer
004663OtherCTLCSW CT LIC #

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
I20231004001848 CT Practitioner - Clinical Social Worker 7719332105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

770 Saybrook Rd
BLDG B
Middletown, CT 06457-4739
Phone (860) 227-5962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004663CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Donahue P, C & S LLC CurrentSince Aug 9, 2023 Accepting new patients

Locations

770 Saybrook Rd
Bldg B
Middletown, CT 06457
Phone (860) 227-5962

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, 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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1538120332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SPRINGBROOK DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673623",
            "telephone_number": "860-227-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD BLDG B",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-227-5962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1177 Silas Deane Hwy",
            "address_purpose": "LOCATION",
            "city": "Wethersfield",
            "state": "CT",
            "postal_code": "061094348",
            "country_code": "US",
            "telephone_number": "860-227-5962",
            "fax_number": "860-757-3941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "DAPHNE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW CT LIC #",
            "identifier": "004663",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.