Individual provider Active NPI

Darryl Jerome Saunders

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1922574136
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
016286 Issued in CT
Practice address
663 Lakewood Rd Ste 3
Waterbury, CT 06704-2492
Phone
(203) 802-7502
Fax
(203) 527-5342
NPI assigned
Oct 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 016286 CT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CT

Addresses

Primary practice location

663 Lakewood Rd Ste 3
Waterbury, CT 06704-2492

Mailing address

114 Grilleytown Rd
Waterbury, CT 06704-2409
Phone (203) 802-7502

Other identifiers 1

IdentifierTypeStateIssuer
101YA0400XMedicaidCT

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
I20260624004212 CT Practitioner - Clinical Social Worker 5294208831 Practice locations: Waterbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 Grilleytown Rd
Waterbury, CT 06704-2409

663 Lakewood Rd
Suite 3
Waterbury, CT 06704-2492
Phone (203) 802-7502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016286CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life'S Vision Counseling and Mentoring Services LLC Current Accepting new patients
Family Intervention Center, Inc Addiction (Substance Use Disorder) Past Accepting new patients

Locations

663 Lakewood Rd
Ste 3
Waterbury, CT 06704
Phone (203) 500-0345

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1922574136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GRILLEYTOWN RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067042409",
            "telephone_number": "203-802-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 LAKEWOOD RD STE 3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067042492",
            "telephone_number": "203-802-7502",
            "fax_number": "203-527-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "DARRYL",
        "middle_name": "JEROME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "016286",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.