Individual provider Active NPI

Katherine Draine, L.I.C.S.W.

  • Clinical Social Worker
  • Concord, MA
National Provider Identifier
1396454823
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110696 Issued in MA
Practice address
70 Beharrell St Apt 308
Concord, MA 01742-1745
Phone
(978) 390-9090
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 110696 MA Primary

Addresses

Primary practice location

70 Beharrell St Apt 308
Concord, MA 01742-1745

Mailing address

70 Beharrell St Apt 308
Concord, MA 01742-1745
Phone (978) 390-9090

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110696MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1396454823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BEHARRELL ST APT 308",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421745",
            "telephone_number": "978-390-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BEHARRELL ST APT 308",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421745",
            "telephone_number": "978-390-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAINE",
        "first_name": "KATHERINE",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.