Individual provider Active NPI

Danielle McIntyre

  • Clinical Social Worker
  • Wallingford, CT
National Provider Identifier
1790593101
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14787 Issued in CT
Practice address
420 Hope Hill Rd
Wallingford, CT 06492-2226
Phone
(203) 915-7184
NPI assigned
Dec 19, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 14787 CT Primary

Addresses

Primary practice location

420 Hope Hill Rd
Wallingford, CT 06492-2226

Mailing address

420 Hope Hill Rd
Wallingford, CT 06492-2226
Phone (203) 915-7184

Other practice location 1

123 Middle St
Bristol, CT 06010-7404
Phone (860) 281-2280

Other practice location 2

640 Main St
Plantsville, CT 06479-1580
Phone (860) 281-2280

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
I20251023003147 CT Practitioner - Clinical Social Worker 3870081524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Hartford DispensaryGroup PAC ID 4789010984, 11 clinicians
Peaceful Mind Behavioral Health and Wellness LLCGroup PAC ID 0941683056, 15 clinicians

Practice addresses (Care Compare)

1098 Farmington Ave
Bristol, CT 06010-4705
Phone (860) 589-6433

123 Middle St
Bristol, CT 06010-7404
Phone (860) 281-2280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14787CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Dispensary CurrentSince Jul 28, 2025 Accepting new patients
Peaceful Mind Behavioral Health & Wellness, LLC Clinical CurrentSince Aug 11, 2025 Accepting new patients
Peaceful Mind Behavioral Health & Wellness, LLC Clinical CurrentSince Aug 11, 2025 Accepting new patients

Locations

1098 Farmington Ave
Bristol, CT 06010
Phone (860) 589-6433

123 Middle St
Bristol, CT 06010
Phone (860) 281-2280

335 Broad St
Manchester, CT 06040
Phone (860) 643-3200

542 E Main St
New Britain, CT 06051
Phone (860) 827-3313

Organizations & group practices 3

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": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1790593101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 HOPE HILL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922226",
            "telephone_number": "203-915-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 HOPE HILL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922226",
            "telephone_number": "203-915-7184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Middle St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060107404",
            "country_code": "US",
            "telephone_number": "860-281-2280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Main St",
            "address_purpose": "LOCATION",
            "city": "Plantsville",
            "state": "CT",
            "postal_code": "064791580",
            "country_code": "US",
            "telephone_number": "860-281-2280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.