Individual provider Active NPI

Katharine Smulski, LCSW

  • Clinical Social Worker
  • Berlin, CT
National Provider Identifier
1356035562
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13087 Issued in CT
Practice address
211 Vineyard Dr
Berlin, CT 06037-1830
Phone
(860) 559-0248
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 13087 CT Primary

Addresses

Primary practice location

211 Vineyard Dr
Berlin, CT 06037-1830

Mailing address

211 Vineyard Dr
Berlin, CT 06037-1830
Phone (860) 559-0248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20231108001685 CT Practitioner - Clinical Social Worker 8325495633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Coastal Connecticut Counseling LLCGroup PAC ID 8527361161, 9 clinicians

Practice addresses (Care Compare)

2960 Post Rd
Suite 3B2
Southport, CT 06890-1268
Phone (203) 307-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13087CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Connecticut Counseling LLC CurrentSince Oct 16, 2023 Accepting new patients
Traverse Point Counseling PastSince Jun 11, 2023 Accepting new patients

Locations

1 Eliot Pl
#3C
Fairfield, CT 06824

58 Wellington Rd
Milford, CT 06461
Phone (203) 307-3030

2960 Post Rd
Ste 3B2
Southport, CT 06890
Phone (203) 307-3030

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1356035562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 VINEYARD DR",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371830",
            "telephone_number": "860-559-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 VINEYARD DR",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371830",
            "telephone_number": "860-559-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULSKI",
        "first_name": "KATHARINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

Sources for this page

Verify at the official NPI Registry.