Individual
DANIELLE N MASTRIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,BA,LMSW,LADC
Contact information
Practice address
141 E MAIN ST, 3RD FLOOR HOME BASED SERVICES, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 574-3315
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1124
CT
104100000X
Social Worker
000078
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008057354
—
CT
01
—
12801295
CAQH
—
01
—
CAC-6076
CONNECTICUT CERTIFICATION BOARD, INC
CT
01
—
ICADC-6076
CONNECTICUT CERTIFICATION BOARD, INC.
CT
Enumeration date
09/13/2012
Last updated
11/19/2019
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