Kathryn Hamma Clavin-Vunkannon, LMSW, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

085891 Issued in NY

Practice address

24 Winding Path
Manorville, NY 11949-2251

Phone

(631) 905-9998

NPI assigned

Jun 13, 2014

Last updated

Jan 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kathryn Hamma Clavin Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aid to the Developmentally Disabled, Inc

  dba Rise Life Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverhead, NY
  • NPI 1912575762
  Medicare reassignment NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1508325184

  NY

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1114331410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WINDING PATH",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492251",
            "telephone_number": "631-905-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WINDING PATH",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492251",
            "telephone_number": "631-905-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVIN-VUNKANNON",
        "first_name": "KATHRYN",
        "middle_name": "HAMMA",
        "credential": "LMSW, LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "31376",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "085650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "CLAVIN",
            "middle_name": "HAMMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ka Lun Benny Chan, RPH
• Fang Chen, MD
• Sanjeev Chopra, P.T.
• Mary Cirko, LMT
• Christine A Clark, LPN
• Constance Cleary, RN
• Linda A Cohen, M.S., C.C.C.
• Mikayla Coleman
• Randi L Connelly, OTRL
• Patricia Conroy

• Clinical Social Worker in Manorville, NY
• Providers in Manorville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.