Katherine Walworth, MA,BA,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002867 Issued in CT

Practice address

20 Elm St
Unit 2
Stonington, CT 06378-1259

Phone

(860) 303-7166

NPI assigned

Feb 4, 2016

Last updated

Aug 28, 2017By 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 4

Other names 1

• Ms. Katherine Walworth Professional name

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bona Vita Wellness and Psychiatric CenterGroup PAC ID 9133449796, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Master of Arts

Practice roles

Locations

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.

• Bona Vita Wellness and Psychiatric Center

  • Psychiatry Physician
  • Milford, CT
  • NPI 1245631126
  Medicare reassignment Care Compare group NPD
• Awaken the Power Therapy, LLC

  • Clinical Social Worker
  • Milford, CT
  • NPI 1194129239

  Professional

  NPD (past)

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1366800369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 RIVERS STREET",
            "address_2": "SUITE 10",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "06460",
            "telephone_number": "203-693-1050",
            "fax_number": "203-306-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ELM ST",
            "address_2": "UNIT 2",
            "city": "STONINGTON",
            "state": "CT",
            "postal_code": "063781259",
            "telephone_number": "860-303-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALWORTH",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "MA,BA,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI-PLAN",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13863724",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "WALWORTH",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Stonington, CT
• Providers in Stonington, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.