Katrina Rudd, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120203 Issued in MA

Practice address

101 1St Ave Ste 6
Waltham, MA 02451-1160

Phone

(781) 693-5141

NPI assigned

Jul 24, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1073090973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PARK TER APT A",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024741227",
            "telephone_number": "207-272-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 1ST AVE STE 6",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511160",
            "telephone_number": "781-693-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "KATRINA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Rowley
• Jessica L Roy, MS RD LDN
• Teresa Roy
• Stefi Gail Rubin, PH.D.
• Andrea Ruby, NP
• Elaine B Rudel, MS, SLP-CCC
• Franziska Rudorf
• Maxwell Ruel
• Odell Ruffin
• Kristine Maria Ruggiero, PNP, PHD

• Clinical Social Worker in Waltham, MA
• Providers in Waltham, 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 Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.