Individual provider Active NPI

Katherine Anne Chesson, MSW, LICSW

  • Clinical Social Worker
  • Pawcatuck, CT
National Provider Identifier
1194964098
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
43 W Broad St Unit 1
Pawcatuck, CT 06379-4307
Phone
(401) 219-1133
Fax
(401) 596-1826
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

43 W Broad St
Unit 1
Pawcatuck, CT 06379-4307
Phone (401) 219-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 enrollments
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.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130412000317 RI Practitioner - Clinical Social Worker 7911143102 Practice locations: Westerly, RI
I20210416000903 CT Practitioner - Clinical Social Worker 7911143102 Practice locations: Pawcatuck, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shaune Martin Therapy CurrentSince May 4, 2025 Accepting new patients

Locations

43 W Broad St
Unit 1
Pawcatuck, CT 06379
Phone (401) 219-1133

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

NPPES NPI Registry

Primary practice location

43 W Broad St Unit 1
Pawcatuck, CT 06379-4307

Mailing address

43 W Broad St
Pawcatuck, CT 06379-4306
Phone (401) 219-1133

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
008034891MedicaidCT
601201821MedicaidRI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 29, 2025.

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194964098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 W BROAD ST",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063794306",
            "telephone_number": "401-219-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 W BROAD ST UNIT 1",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063794307",
            "telephone_number": "401-219-1133",
            "fax_number": "401-596-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESSON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008034891",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601201821",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawcatuck, CT

Sources for this page

Verify at the official NPI Registry.