Kathleen Douglas, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006591 Issued in CT

Practice address

Fleet & Family Support Center
Box 93 Navsubasenlon
Groton, CT 06349-5093

Phone

(860) 694-4961

Fax

(860) 694-4018

NPI assigned

Jul 29, 2006

Last updated

Apr 9, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Kathleen Douglas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• L&M Physician Association, Inc

  • Family Medicine Physician
  • Ledyard, CT
  • NPI 1386972693

  Clinical

  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1285649111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MT PARNASSUS RD",
            "city": "EAST HADDAM",
            "state": "CT",
            "postal_code": "06423",
            "telephone_number": "860-873-3439",
            "fax_number": "860-873-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FLEET & FAMILY SUPPORT CENTER",
            "address_2": "BOX 93 NAVSUBASENLON",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495093",
            "telephone_number": "860-694-4961",
            "fax_number": "860-694-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "006591",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DOUGLAS",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emma Donnell, PHARMD, RPH
• Alison Doolittle, BA, MSW INTERN
• F. Henry Doran, D.MIN, LPC
• Michael Paul Dorris
• John William Dorunda, M.D.
• Rebecca Lynn Dow, L.O.
• Dr S D Goldberg LLC
• Dr. Gemma S. Stirba, LLC
• Vanessa Florence Drabek
• Hallie C. Draper, LCSW

• Clinical Social Worker in Groton, CT
• Providers in Groton, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.