Active NPI
Caitlin Breida Connolly, MSW
- Clinical Social Worker
- Bellingham, WA
National Provider Identifier
1376741595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60341266
- Practice address
- 1229 Cornwall Ave Ste 209
Bellingham, WA 98225-5023 - Phone
- (518) 281-8665
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60341266 | WA | Primary |
Addresses
Primary practice location
1229 Cornwall Ave Ste 209
Bellingham, WA 98225-5023
Mailing address
1229 Cornwall Ave Ste 209
Bellingham, WA 98225-5023
Phone (518) 281-8665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 30, 2025 through Jan 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60341266 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1376741595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 CORNWALL AVE STE 209",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982255023",
"telephone_number": "518-281-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 CORNWALL AVE STE 209",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982255023",
"telephone_number": "518-281-8665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "CAITLIN",
"middle_name": "BREIDA",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60341266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.