Individual provider Active NPI

Katherine Sawyer, LICSW, MLADC

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1558566489
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1497 Issued in NH
Practice address
2 Wall St
Suite 300
Manchester, NH 03101-1518
Phone
(603) 668-4111
Fax
(603) 628-7757
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0801 NH
Clinical Social Worker 1041C0700X 1497 NH Primary

Addresses

Primary practice location

2 Wall St
Suite 300
Manchester, NH 03101-1518

Mailing address

6 Buttrick Rd
Ste 102
Londonderry, NH 03053-3417
Phone (603) 537-1300

Other identifiers 2

IdentifierTypeStateIssuer
7706638YONH01OtherANTHEM
81263824MedicaidNH

Other names 1

  • Katherine Ellsworth Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20100303000398 NH Practitioner - Clinical Social Worker 5395880272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone (603) 537-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0801NHMDOptometrist
1497NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Derry Medical Center, PA CurrentSince Jan 17, 2022 Accepting new patients

Locations

14 Tsienneto Rd
Bldg B
Derry, NH 03038

6 Tsienneto Rd
Ste 100
Derry, NH 03038

50 Michels Way
Unit 102
Londonderry, NH 03053

6 Buttrick Rd
Ste 102
Londonderry, NH 03053
Phone (603) 537-1308

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1558566489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BUTTRICK RD",
            "address_2": "STE 102",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533417",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST",
            "address_2": "SUITE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "KATHERINE",
        "credential": "LICSW, MLADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0801",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "7706638YONH01",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81263824",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St",
            "address_2": "suite 300",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031011518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "ELLSWORTH",
            "credential": "LICSW, MLADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.