Kathryn Bagley, MSW
Individual provider Active NPI Social Worker · New Canaan, CT
NPI 1619590999 · NPPES record last updated Mar 9, 2026
Key facts
- NPI
- 1619590999
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 012858 (CT)
- Practice address
- 468 South Ave
New Canaan, CT 06840-6321 - Phone
- (203) 594-4575
- NPI assigned
- May 21, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southbury Adolescent and Young Adult Counseling Center
Practice addresses (Care Compare)
14 Commerce Rd
Newtown, CT 06470-1607
Phone (203) 568-5923
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240223002540 | CT | Practitioner - Clinical Social Worker | 3072958586 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012858 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wheeler Clinic | Past |
Accepting new patients |
Interoperability endpoints
- kathryn.bagley.p1@direct.wheelerclinic.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 012858 | CT | Yes |
Addresses
Primary practice location
468 South Ave
New Canaan, CT 06840-6321
Mailing address
45 Pawtucket Ave
Shelton, CT 06484-5546
Phone (203) 615-8385
Other providers in New Canaan, CT
- Dylan Antonioli
- Irina Arkhipova-Jenkins
- Lisa Sue Arnold
- Arts for Healing, Inc.
- Sean Christopher Awuku
- Larry W Barnett
- Marybeth Wetzel Bates
- Beautiful Acupuncture
- Catherine Leigh Beeson
- Kathleen Mary Berchelmann
All providers in New Canaan, CT · Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.