Active NPI
Katharine Stabler Dorman, LICSW
- Clinical Social Worker
- Plymouth, MA
National Provider Identifier
1114140613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 103960
- Practice address
- 2 School St
Plymouth, MA 02360-3964 - Phone
- (508) 830-1234
- NPI assigned
- Apr 11, 2007
- Last updated
- Mar 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 103960 | MA | Primary |
Addresses
Primary practice location
2 School St
Plymouth, MA 02360-3964
Mailing address
2 School St
Plymouth, MA 02360-3964
Phone (508) 830-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000P03798 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 13, 2021 through Oct 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103960 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332115200000",
"number": "1114140613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SCHOOL ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023603964",
"telephone_number": "508-830-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SCHOOL ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023603964",
"telephone_number": "508-830-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STABLER DORMAN",
"first_name": "KATHARINE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2012-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "103960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0000P03798",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.