Individual provider Active NPI

Kathleen M Corkery, LICSW

  • Clinical Social Worker
  • Bedford, NH
National Provider Identifier
1407859697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
720 Issued in NH
Practice address
360 Route 101
Ste 10
Bedford, NH 03110-5031
Phone
(603) 472-2846
Fax
(603) 472-2872
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 720 NH Primary

Addresses

Primary practice location

360 Route 101
Ste 10
Bedford, NH 03110-5031

Mailing address

360 Route 101
Ste 10
Bedford, NH 03110-5031
Phone (603) 472-2846

Other identifiers 1

IdentifierTypeStateIssuer
30011183MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20031230000506 NH Practitioner - Clinical Social Worker 7315845120 Practice locations: Bedford, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

201 Riverway PL
Bedford, NH 03110-6763
Phone (603) 668-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
720NHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen M. Corkery Clinical CurrentSince Jun 7, 2019 Accepting new patients

Locations

201 Riverway Pl
Bedford, NH 03110
Phone (603) 494-0682

Organizations & group practices 1

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407859697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "STE 10",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105031",
            "telephone_number": "603-472-2846",
            "fax_number": "603-472-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "STE 10",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105031",
            "telephone_number": "603-472-2846",
            "fax_number": "603-472-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORKERY",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011183",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.