Active NPI
Cynthia Daigneault, LCSW, LADC, EMT
- Clinical Social Worker
- Groton, CT
National Provider Identifier
1699335372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW02137
- Practice address
- 1 Wahoo Ave
Groton, CT 06349-2324 - Phone
- (860) 694-4020
- NPI assigned
- Jun 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 001310 | CT | |
| Clinical Social Worker | 1041C0700X | 4141 | CT | |
| Basic Emergency Medical Technician | 146N00000X | 941502 | CT | |
| Clinical Social Worker | 1041C0700X | CSW02137 | RI | Primary |
Addresses
Primary practice location
1 Wahoo Ave
Groton, CT 06349-2324
Mailing address
PO Box 33
North Stonington, CT 06359-0033
Phone (860) 710-7312
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CSW02137 | Medicaid | RI | |
| 001310 | Medicaid | CT | |
| 941502 | Medicaid | CT | |
| 4141 | Medicaid | CT |
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
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4141 | CT | MD | Clinical Social Worker |
| CSW02137 | RI | MD | Clinical Social Worker |
| 001310 | CT | MD | Registered Dietitian |
| 941502 | CT | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1699335372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33",
"city": "NORTH STONINGTON",
"state": "CT",
"postal_code": "063590033",
"telephone_number": "860-710-7312",
"fax_number": "860-599-3988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WAHOO AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "063492324",
"telephone_number": "860-694-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAIGNEAULT",
"first_name": "CYNTHIA",
"credential": "LCSW, LADC, EMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-16",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "001310",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "4141",
"primary": false
},
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "CT",
"license": "941502",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW02137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CSW02137",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001310",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "941502",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4141",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.