Individual provider Active NPI

Katherine S Wenger, LICSW

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1255401717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1030653 Issued in MA
Practice address
10 Chestnut St
Needham, MA 02492
Phone
(781) 449-1143
Fax
(781) 449-5992
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1030653 MA Primary

Addresses

Primary practice location

10 Chestnut St
Needham, MA 02492

Mailing address

8 Coltsway
Unit P
Wayland, MA 01778
Phone (978) 808-2516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20040819000907 MA Practitioner - Clinical Social Worker 2062485758 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1415 Beacon St
Brookline, MA 02446-4816
Phone (978) 808-2516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255401717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COLTSWAY",
            "address_2": "UNIT P",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "01778",
            "telephone_number": "978-808-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CHESTNUT ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "781-449-1143",
            "fax_number": "781-449-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "KATHERINE",
        "middle_name": "S",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1030653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.