MEDICARE: DANIELLE MEAGH-KNAUFT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	005661	CT
2	1041S0200X	School Social Worker		CT

General Provider Information

NPI Number	:	1417335191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MEAGH-KNAUFT LCSW

Provider Business Mailing Address
First Line	:	24 MOUNTAIN VIEW TER
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-4427
Country	:	US
Telephone Number	:	860-938-2164
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 MOUNTAIN VIEW TER
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-4427
Country	:	US
Telephone Number	:	860-938-2164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2015
Last Update Date	:	05/13/2015

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