Kaitlyn Marie Fenner, MWS

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

12 Phoenix St
Vernon, CT 06066-5416

Phone

(860) 614-4777

NPI assigned

Sep 13, 2013

Sex

Female

Sole proprietor

No

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

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clifford W Beers Guidance Clinic IncGroup PAC ID 1951771054, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clifford W. Beers Guidance Clinic Inc

  • Adolescent and Children Mental Health Clinic/Center
  • New Haven, CT
  • NPI 1073526968
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1639504202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PHOENIX ST",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665416",
            "telephone_number": "860-614-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PHOENIX ST",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665416",
            "telephone_number": "860-614-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNER",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle-Marie Lynch Fako, RBT
• Family Affirmation Center for Treatment
• Family Affirmation Center for Treatment, LLC
• Family Services of Eastern Connecticut, LLC
• Pamela M Feldman, LADC
• Melanie Fiddler, RPH
• First Choice Health Centers, Inc.
• First Choice Health Centers, Inc.
• First Choice Health Centers, Inc.
• First Choice Health Centers, Inc.

• Social Worker in Vernon, CT
• Providers in Vernon, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.

Verify at the official NPI Registry.