Individual provider Active NPI

Paul T Cancro, MSW

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1538388541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
50 Brookside Rd
Waterbury, CT 06708-1402
Phone
(203) 755-4490
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

50 Brookside Rd
Waterbury, CT 06708-1402

Mailing address

18 Sky Hill Dr
Wolcott, CT 06716-1817
Phone (203) 755-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • 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
I20190913002240 CT Practitioner - Clinical Social Worker 9436488558 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Behavioral Health Assoc, P.C. Clinical CurrentSince Jul 15, 2019 Accepting new patients

Locations

85 Lexington St
New Britain, CT 06052
Phone (860) 223-1111

41 Faire Harbour Pl
New London, CT 06320
Phone (860) 437-6914

41 Old Turnpike Rd
Southington, CT 06489
Phone (860) 276-9295

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538388541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SKY HILL DR",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067161817",
            "telephone_number": "203-755-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BROOKSIDE RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081402",
            "telephone_number": "203-755-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCRO",
        "first_name": "PAUL",
        "middle_name": "T",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.