Individual provider Active NPI

Kathryn Elizabeth Tunison, LCSW-R

  • Clinical Social Worker
  • Watkins Glen, NY
National Provider Identifier
1477509800
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
057947 Issued in NY
Practice address
106 S Perry St
Ste 4
Watkins Glen, NY 14891-1615
Phone
(607) 535-8282
Fax
(607) 535-8284
NPI assigned
May 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 057947 NY Primary

Addresses

Primary practice location

106 S Perry St
Ste 4
Watkins Glen, NY 14891-1615

Mailing address

178 Tucker Rd
Trumansburg, NY 14886-9771

Other identifiers 1

IdentifierTypeStateIssuer
07300069213LIMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Sep 1, 2016 through Sep 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
057947NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Mental Health Clinical PastSince Oct 1, 1992 Accepting new patients
Schuyler County Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477509800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 TUCKER RD",
            "city": "TRUMANSBURG",
            "state": "NY",
            "postal_code": "148869771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST",
            "address_2": "STE 4",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911615",
            "telephone_number": "607-535-8282",
            "fax_number": "607-535-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNISON",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "057947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07300069213LI",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkins Glen, NY

Sources for this page

Verify at the official NPI Registry.