Individual provider Active NPI

Kaitlynn Elaine Haugen, LCSW

  • Clinical Social Worker
  • Astoria, NY
National Provider Identifier
1144762907
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087905 Issued in NY
Practice address
2211 33Rd St Apt 2C
Astoria, NY 11105-2440
Phone
(516) 592-0916
NPI assigned
Nov 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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 087905 NY Primary

Addresses

Primary practice location

2211 33Rd St Apt 2C
Astoria, NY 11105-2440

Mailing address

2211 33Rd St Apt 2C
Astoria, NY 11105-2440
Phone (516) 592-0916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087905NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1144762907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 33RD ST APT 2C",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052440",
            "telephone_number": "516-592-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 33RD ST APT 2C",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052440",
            "telephone_number": "516-592-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "KAITLYNN",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.