Individual provider Active NPI

Kaitlin Laeng, LICSW

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1073331187
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW126634 Issued in MA
Practice address
500 Cummings Ctr Ste 3100
Beverly, MA 01915-6540
Phone
(978) 921-4000
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW126634 MA Primary

Addresses

Primary practice location

500 Cummings Ctr Ste 3100
Beverly, MA 01915-6540

Mailing address

500 Cummings Ctr Ste 3100
Beverly, MA 01915-6540

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250121002459 MA Practitioner - Clinical Social Worker 5890224836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Cummings Ctr
Suite 3100
Beverly, MA 01915-6540
Phone (978) 921-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Nov 17, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Nov 17, 2024 Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

500 Cummings Ctr
Ste 3100
Beverly, MA 01915
Phone (978) 716-6774

140 Wood Rd
#206
Braintree, MA 02184

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1073331187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CUMMINGS CTR STE 3100",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CUMMINGS CTR STE 3100",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156540",
            "telephone_number": "978-921-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAENG",
        "first_name": "KAITLIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.