Louisa Rachel Khettab, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

124051 Issued in MA

Practice address

25 Bank Row St FL 3
Greenfield, MA 01301-3599

Phone

(413) 367-4938

NPI assigned

Feb 26, 2014

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clinical and Support Options, Inc

  • Respite Care
  • Greenfield, MA
  • NPI 1770908188
  NPD (past)

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1528483666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BANK ROW ST FL 3",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013013599",
            "telephone_number": "413-367-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BANK ROW ST FL 3",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013013599",
            "telephone_number": "413-367-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETTAB",
        "first_name": "LOUISA",
        "middle_name": "RACHEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Dawn Kenney
• Catherine A. Kentfield
• Caroline Kern
• Rebecca Elizabeth Kern, MA
• Christina M Kerr, LCSW
• Ella Kibler, BSW
• Karolyn B Kiehn, APRN
• Daniel Patrick Kiely Jr., RN
• Marla R. Killough, MSW
• Janice Kilmer

• Clinical Social Worker in Greenfield, MA
• Providers in Greenfield, 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 Jun 7, 2023; 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.