Lydia Catherine Kingsbury

Individual provider Active NPI Social Worker · Vineyard Haven, MA

NPI 1306561279 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1306561279
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
228177 (MA)
Practice address
111 Edgartown Rd
Vineyard Haven, MA 02568-5699
Phone
(508) 693-7900
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
228177MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Community Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 228177 MA Yes

Addresses

Primary practice location

111 Edgartown Rd
Vineyard Haven, MA 02568-5699

Mailing address

111 Edgartown Rd
Vineyard Haven, MA 02568-5699
Phone (508) 693-7900

Other providers in Vineyard Haven, MA

All providers in Vineyard Haven, MA · Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.