Kathleen E. Connolly, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115945 Issued in MA

Practice address

250 Spring St Apt 3
West Roxbury, MA 02132-5017

Phone

(617) 676-5333

NPI assigned

Apr 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1487117008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SPRING ST APT 3",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021325017",
            "telephone_number": "617-676-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SPRING ST APT 3",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021325017",
            "telephone_number": "617-676-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KATHLEEN",
        "middle_name": "E.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115845",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Coll, BS
• Sarah Margaret Collins, AGNP
• Ari Comart
• Dara Concagh, LICSW
• Paul Richard Conlin, MD
• Mary Connolly, PA
• Patricia Ann Connors, M.S.W., L.I.C.S.W.
• Chester H Conrad, M.D., PH.D.
• Brisa Consoletti
• Chase Gregory Conway, DPT

• Clinical Social Worker in West Roxbury, MA
• Providers in West Roxbury, 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 7, 2022; 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.