Individual provider Active NPI

Kathryn A King, L.C.S.W.

  • Clinical Social Worker
  • Branford, CT
National Provider Identifier
1093724114
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003198 Issued in CT
Practice address
1078 Main St Unit 4
Branford, CT 06405-3716
Phone
(203) 483-6096
NPI assigned
Aug 7, 2006
Last updated
Feb 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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 003198 CT Primary

Addresses

Primary practice location

1078 Main St Unit 4
Branford, CT 06405-3716

Mailing address

22 Sagamore Cove Rd
Branford, CT 06405-5020
Phone (203) 483-6096

Other identifiers 2

IdentifierTypeStateIssuer
10743398OtherCTC.A.Q.H. ID
140003198CT03OtherCTANTHEM ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090923000685 CT Practitioner - Clinical Social Worker 7719031137 Practice locations: Branford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 S Main St
Suite 1
Branford, CT 06405-3872
Phone (203) 499-8605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3198CTMDRegistered Dietitian
003198CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Town of Branford Clinical PastSince Nov 6, 1990 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1093724114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SAGAMORE COVE RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064055020",
            "telephone_number": "203-483-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 MAIN ST UNIT 4",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053716",
            "telephone_number": "203-483-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C.A.Q.H. ID",
            "identifier": "10743398",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "140003198CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.