Katie Sarah Infantine

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120264 Issued in MA

Practice address

843 Massachusetts Ave
Cambridge, MA 02139-3077

Phone

(617) 237-0498

NPI assigned

Oct 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 23, 2023 through Jan 23, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.katieinfantine@147611.advancedmd-direct.com

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1386928299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRATTLE DR APT 35",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024742857",
            "telephone_number": "978-771-6041",
            "fax_number": "508-634-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393077",
            "telephone_number": "617-237-0498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017571750",
            "country_code": "US",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INFANTINE",
        "first_name": "KATIE",
        "middle_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120264",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Imperatore, PHD
• Impossible Knots, LMT
• In Sync Physical Therapy, LLC
• Tayla Krystine Inderlin, PHARMD
• Laura Indigo, FNTP, MRWP, BCTMB
• George R Ingham, LICSW
• Inman Pharmacy, Inc
• Phyllis J Inman, NP
• Inner Bridges Physical Therapy and Wellness, Inc.
• Tomomi Inomata, MD

• Clinical Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.