Kathy Massonne, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003465A Issued in IN

Practice address

333 E Lewis St
Fort Wayne, IN 46802-3139

Phone

(260) 426-3347

Fax

(260) 424-2248

NPI assigned

Jun 23, 2017

Sex

Female

Sole proprietor

Yes

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 IN

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

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.

• Bowen Health Inc

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810

  IN

  Medicare reassignment NPD
• Marillac Counseling, LLC

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1033783766

  Clinical

  NPD Authorized official
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD
• Lutheran Social Services of Indiana Inc.

  • Counselor
  • Fort Wayne, IN
  • NPI 1861636136
  NPD

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639699366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347",
            "fax_number": "260-424-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347",
            "fax_number": "260-424-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSONNE",
        "first_name": "KATHY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003465A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Massage Therapy Clinc
• Massage Works Therapy Center LLC
• Jerome D. Massenburg, M.D.
• Kara Massey
• Deanna L. Massie, CNS
• Mastbaum Endocrinology
• Leonard I Mastbaum, MD
• Marni F Mastbaum, MS ED
• Emily Mastelou-Page, NNP
• Kirk E Masten, DO

• All providers in Fort Wayne, IN
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.