Kate O Logan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9196 Issued in CT

Practice address

176 Main St
Southbridge, MA 01550-2561

Phone

(508) 765-2725

NPI assigned

Sep 14, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1447500723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CORNFIELD PT",
            "city": "WOODSTOCK",
            "state": "CT",
            "postal_code": "062813003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502561",
            "telephone_number": "508-765-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "KATE",
        "middle_name": "O",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004040564",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominic J Liantonio, LMHC
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• Wendy Ligeti, P.A,
• Brianna Limbaugh
• Vladas Litani, MD
• Matthew Lubomirski
• Tanya P. Lucas, M.D.
• Mirza Lugardo, LMHC, LADC-I
• Nicole Marie Lynn Fillipon, D.O.
• Emily Macey

• Clinical Social Worker in Southbridge, MA
• Providers in Southbridge, 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 Feb 4, 2019; 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.