Active NPI
Kaitlyn McDonald Ollila
- Clinical Social Worker
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 120432
- Practice address
- 1 Boston Medical Ctr PL
Boston, MA 02118-2908 - Phone
- (617) 414-2593
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 120432 | MA | Primary |
Addresses
Primary practice location
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Mailing address
6 Davey LN
Winchester, MA 01890-3170
Phone (339) 227-2454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110072510A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1666 Massachusetts Ave
Suite 10
Lexington, MA 02420-5313
Phone (855) 284-7483
872 Mass Ave
Suite 2 2
Cambridge, MA 02139-3072
Phone (855) 284-7483
90 Canal St
Suite 4
Boston, MA 02114-2022
Phone (866) 630-0966
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120432 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589
90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889
872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1578041505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 DAVEY LN",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018903170",
"telephone_number": "339-227-2454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BOSTON MEDICAL CTR PL",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182908",
"telephone_number": "617-414-2593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLLILA",
"first_name": "KAITLYN",
"middle_name": "MCDONALD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-01",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "120432",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110072510A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.