Individual provider Active NPI

Kaitlin Frances Holihan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1548046824
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12309 Issued in CT
Practice address
88 Grandview Ave
Waterbury, CT 06708-2509
Phone
(203) 573-6000
NPI assigned
Sep 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12309 CT Primary

Addresses

Primary practice location

88 Grandview Ave
Waterbury, CT 06708-2509

Mailing address

139 Clay St
Thomaston, CT 06787-1412
Phone (860) 919-5507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231011000200 CT Practitioner - Nurse Practitioner 0840645891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

88 Grandview Ave
Waterbury, CT 06708-2509
Phone (203) 573-7265

Hospital & facility affiliations

  • Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12309CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Apr 2, 2025 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

88 Grandview Ave
Waterbury, CT 06708
Phone (203) 573-6103

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1548046824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CLAY ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871412",
            "telephone_number": "860-919-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082509",
            "telephone_number": "203-573-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIHAN",
        "first_name": "KAITLIN",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.