Katherine Canavan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114332 Issued in MA

Practice address

31 Heath St
Jamaica Plain, MA 02130-1650

Phone

(617) 523-6400

Fax

(617) 523-6400

NPI assigned

May 10, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Service Association of Greater Boston

  • Community/Behavioral Health Agency
  • Jamaica Plain, MA
  • NPI 1801916176
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1649484387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CLARENDON ST",
            "address_2": "APT 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021166027",
            "telephone_number": "617-388-4194",
            "fax_number": "617-388-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HEATH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301650",
            "telephone_number": "617-523-6400",
            "fax_number": "617-523-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "KATHERINE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne E Caissie
• Tulay Cakiner-Egilmez, NP
• Kathleen Rose Callahan, LICSW
• Susan Caloggero
• Katharine Kingsley Campbell, NP
• Marcos Cancado
• Kaitlin Johnson Canha
• Kelly Cardalino, M. ED.
• Melissa Ann Cardenas
• Christina Cardwell

• Clinical Social Worker in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.