Kaylin Petracca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

220593 Issued in MA

Practice address

32 Hamilton Ave
Milford, MA 01757-1748

Phone

(508) 634-3420

NPI assigned

Dec 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 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.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  MA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1043755937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HAMILTON AVE",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571748",
            "telephone_number": "508-634-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 HAMILTON AVE",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571748",
            "telephone_number": "508-634-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRACCA",
        "first_name": "KAYLIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-30",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "220593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Peterson
• Katie Beth Peterson
• Leslie Peterson, MPH
• Mitzi Peterson, MSW
• Sonya Peterson
• Laura Jewel Petrillo-Deluca, PAC
• Cheryl Petrola
• Rachel Pflum, CNP
• Brooke Haleigh Phaneuf
• Cheyenne Rose Phaneuf, COTA/L

• Clinical Social Worker in Milford, MA
• Providers in Milford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.