Kathleen Fenno McNulty, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7210-123 Issued in WI

Practice address

1220 Mound Ave
Suite 301
Racine, WI 53404-3350

Phone

(262) 633-3591

Fax

(262) 633-2619

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment Care Compare group NPD
• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Medicare reassignment NPD
• Ascension All Saints Hospital, Inc

  • Community/Retail Pharmacy
  • Mount Pleasant, WI
  • NPI 1164522132
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023027414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MOUND AVE",
            "address_2": "SUITE 301",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043350",
            "telephone_number": "262-633-3591",
            "fax_number": "262-633-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MOUND AVE",
            "address_2": "SUITE 301",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043350",
            "telephone_number": "262-633-3591",
            "fax_number": "262-633-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "KATHLEEN",
        "middle_name": "FENNO",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7210-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40984300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casandra McDowell
• Arlene M. McEntegart, N.P.
• Carrie Joy McFarland
• Aija McGee
• Saundra McGlaston, APNP, PMHNP-BC
• Daniel D Medlock, APNP
• Natalie Meinert, CAPSW
• Alexandra Kim Meitzen, LCSW
• Memorries of the Heart LLC
• Joseph F Menden, RPH

• Clinical Social Worker in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.