Individual
CYNTHIA DAIGNEAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC, EMT
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-4020
Mailing address
PO BOX 33, NORTH STONINGTON, CT 06359-0033
(860) 710-7312
(860) 599-3988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
001310
CT
1041C0700X
Clinical Social Worker
4141
CT
1041C0700X
Clinical Social Worker
Primary
CSW02137
RI
146N00000X
Basic Emergency Medical Technician
941502
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001310
—
CT
05
—
4141
—
CT
05
—
941502
—
CT
05
—
CSW02137
—
RI
Enumeration date
06/16/2019
Last updated
06/17/2019
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