Individual provider Active NPI

Gent Lee Daniels III, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1679920656
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9430 Issued in CT
Practice address
400 Columbus Ave
New Haven, CT 06519-1233
Phone
(203) 503-3171
Fax
(203) 503-3183
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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 9430 CT Primary

Addresses

Primary practice location

400 Columbus Ave
New Haven, CT 06519-1233

Mailing address

400 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3174

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
I20160811000942 CT Practitioner - Clinical Social Worker 7214221431 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince May 31, 2016 Accepting new patients
Gent Daniels, LCSW CurrentSince Sep 28, 2021 Accepting new patients

Locations

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

30 Hazel Ter
Ste A
Woodbridge, CT 06525
Phone (203) 506-1186

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1679920656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3171",
            "fax_number": "203-503-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "GENT",
        "middle_name": "LEE",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.