Individual provider Active NPI

Danielle Erin-Riley Quidgeon, LCSW

  • Clinical Social Worker
  • Norwich, CT
National Provider Identifier
1881011013
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008465 Issued in CT
Practice address
40 Broadway
Norwich, CT 06360-5702
Phone
(860) 887-6536
NPI assigned
Mar 26, 2014
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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 008465 CT Primary

Addresses

Primary practice location

40 Broadway
Norwich, CT 06360-5702

Mailing address

14 8TH St
Plainfield, CT 06374-1303
Phone (860) 884-4042

Other practice location 1

50 Academy Hill Rd
Unit D
Plainfield, CT 06374-1600
Phone (860) 884-4042

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
I20141022000126 CT Practitioner - Clinical Social Worker 5698996379 Practice locations: Plainfield, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008465CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliance Health, Inc Clinical CurrentSince May 1, 2014 Accepting new patients
Reliance Health, Inc PastSince Apr 3, 2022 Accepting new patients

Locations

2 Cliff St
Norwich, CT 06360
Phone (860) 887-1755

40 Broadway
Norwich, CT 06360
Phone (860) 887-6536

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, 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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1881011013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 8TH ST",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063741303",
            "telephone_number": "860-884-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROADWAY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605702",
            "telephone_number": "860-887-6536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 ACADEMY HILL RD",
            "address_2": "UNIT D",
            "address_purpose": "LOCATION",
            "city": "PLAINFIELD",
            "state": "CT",
            "postal_code": "063741600",
            "country_code": "US",
            "telephone_number": "860-884-4042",
            "fax_number": "860-230-2271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIDGEON",
        "first_name": "DANIELLE",
        "middle_name": "ERIN-RILEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.