Individual provider Active NPI

Kathryn L Powers, LICSW, CCSW

  • Clinical Social Worker
  • Londonderry, NH
National Provider Identifier
1194853374
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
251 Issued in NH
Practice address
75 Gilcreast Road
Suite #200
Londonderry, NH 03053-3566
Phone
(603) 552-5155
Fax
(603) 432-3371
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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 251 NH Primary

Addresses

Primary practice location

75 Gilcreast Road
Suite #200
Londonderry, NH 03053-3566

Mailing address

75 Gilcreast Road
Suite #200
Londonderry, NH 03053-3566
Phone (603) 552-5155

Other identifiers 1

IdentifierTypeStateIssuer
30009638MedicaidNH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
251NHMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1194853374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 GILCREAST ROAD",
            "address_2": "SUITE #200",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533566",
            "telephone_number": "603-552-5155",
            "fax_number": "603-432-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 GILCREAST ROAD",
            "address_2": "SUITE #200",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533566",
            "telephone_number": "603-552-5155",
            "fax_number": "603-432-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LICSW, CCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30009638",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Londonderry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.