Kathryn Elaine Roosevelt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8260 Issued in CT

Practice address

21 Chicago Ave
Groton, CT 06340-4907

Phone

(800) 526-3485

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathryn Elaine Clark Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Island Transitions Counseling and Consulting, LLC.

  • Clinical Social Worker
  • Johns Island, SC
  • NPI 1396317145
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1467894055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MILE CREEK RD",
            "address_2": "APT 3D",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711712",
            "telephone_number": "618-559-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CHICAGO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404907",
            "telephone_number": "800-526-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSEVELT",
        "first_name": "KATHRYN",
        "middle_name": "ELAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "CLARK",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Curtis Roberts, IDC
• Thomas Rogers
• Erika Rohdin
• Romania Eye Center, LLC
• Anthony Romania, M.D.
• Howard Christopher Rosas, DC
• Lori Rothrock, PT, MPT
• Nicole Roy
• Jordan Taylor Rucinski, DMD
• Alexander S Ruschetti

• Clinical Social Worker in Groton, CT
• Providers in Groton, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.