Individual provider Active NPI

Dagmara K. Niecikowski, LCSW

  • Clinical Social Worker
  • New Britain, CT
National Provider Identifier
1972821536
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007005 Issued in CT
Practice address
45 Russell St
New Britain, CT 06052-1312
Phone
(860) 348-3371
NPI assigned
May 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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 007005 CT Primary

Addresses

Primary practice location

45 Russell St
New Britain, CT 06052-1312

Mailing address

33 Renn LN
Berlin, CT 06037-3589
Phone (860) 748-5644

Other practice location 1

15 School Street
Creative Interventions
East Ganby, CT 06026
Phone (860) 413-9538

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
I20200821001464 CT Practitioner - Clinical Social Worker 1557787470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

45 Russell St
New Britain, CT 06052-1312
Phone (860) 348-3371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007005CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dagmara Niecikowski, LLC Clinical CurrentSince Feb 1, 2019 Accepting new patients

Locations

45 Russell St
New Britain, CT 06052
Phone (860) 348-3371

Organizations & group practices 1

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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1972821536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 RENN LN",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060373589",
            "telephone_number": "860-748-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RUSSELL ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521312",
            "telephone_number": "860-348-3371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 School Street",
            "address_2": "Creative Interventions",
            "address_purpose": "LOCATION",
            "city": "East Ganby",
            "state": "CT",
            "postal_code": "06026",
            "country_code": "US",
            "telephone_number": "860-413-9538",
            "fax_number": "860-838-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIECIKOWSKI",
        "first_name": "DAGMARA",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.