Individual provider Active NPI

Danielle Charlene Mandujano, MSW, LCSW

  • Clinical Social Worker
  • Milford, DE
National Provider Identifier
1831584630
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0001348 Issued in DE
Practice address
1019 Mattlind Way
Milford, DE 19963-5369
Phone
(302) 459-3455
NPI assigned
Mar 30, 2015
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 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 Q1-0001348 DE Primary

Addresses

Primary practice location

1019 Mattlind Way
Milford, DE 19963-5369

Mailing address

7 Fairway CT
Milford, DE 19963-3770
Phone (302) 494-3397

Other practice location 1

1129 Airport Rd
Milford, DE 19963-6418
Phone (302) 422-8026

Other names 1

  • Danielle Charlene Wiggins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20181211001090 DE Practitioner - Clinical Social Worker 0941572929 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0001348DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jan 31, 2025 Accepting new patients
Imperial Psychiatric Services LLC CurrentSince May 1, 2019 Accepting new patients
Mental Health Specialty Group PA CurrentSince Jul 1, 2025 Accepting new patients

Locations

379 Walmart Dr
Camden, DE 19934
Phone (302) 387-4343

200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200

1000 N West St
Ste 1200
Wilmington, DE 19801
Phone (302) 449-6471

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1831584630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FAIRWAY CT",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199633770",
            "telephone_number": "302-494-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 MATTLIND WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199635369",
            "telephone_number": "302-459-3455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "199636418",
            "country_code": "US",
            "telephone_number": "302-422-8026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDUJANO",
        "first_name": "DANIELLE",
        "middle_name": "CHARLENE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "WIGGINS",
            "middle_name": "CHARLENE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.