Individual provider Active NPI

Kathryn Louise Nevin, LCSW

  • Clinical Social Worker
  • Kennett Square, PA
National Provider Identifier
1407490964
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09104015050 Issued in VA
Practice address
920 E Baltimore Pike
Kennett Square, PA 19348-1800
Phone
(610) 388-7400
NPI assigned
Oct 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 123493 PA
Clinical Social Worker 1041C0700X 09104015050 VA Primary

Addresses

Primary practice location

920 E Baltimore Pike
Kennett Square, PA 19348-1800

Mailing address

920 E Baltimore Pike
Kennett Square, PA 19348-1800
Phone (610) 388-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220323000084 PA Practitioner - Clinical Social Worker 1355736687 Reassigns benefits to 1 organization
I20240903002084 VA Practitioner - Clinical Social Worker 1355736687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Practice addresses (Care Compare)

2340 Commonwealth Dr
Suite 101
Charlottesville, VA 22901-1634
Phone (732) 451-3895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123493PAMDSocial Worker
09104015050VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebulb LLC CurrentSince Jun 1, 2024 Accepting new patients
Meditelecare of Pennsylvania LLC Clinical CurrentSince Feb 10, 2022 Accepting new patients
Thrive Counseling LLC PastSince Sep 1, 2021 Accepting new patients
Meditelecare of Mississippi LLC Social Worker Past Accepting new patients

Locations

11380 Southbridge Pkwy
Alpharetta, GA 30022

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

6210 Old Franconia Rd
#A
Alexandria, VA 22310
Phone (703) 955-3703

2340 Commonwealth Dr
Ste 101
Charlottesville, VA 22901
Phone (732) 451-3895

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1407490964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E BALTIMORE PIKE",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481800",
            "telephone_number": "610-388-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E BALTIMORE PIKE",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481800",
            "telephone_number": "610-388-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVIN",
        "first_name": "KATHRYN",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "123493",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "09104015050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

Verify at the official NPI Registry.