Mary Jane King, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006226 Issued in CT

Practice address

401 West Thames Street
BLDG 301 Southeastern Mental Health Authority
Norwich, CT 06360

Phone

(860) 859-4674

Fax

(860) 859-4790

NPI assigned

Dec 27, 2006

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of ConnecticutGroup PAC ID 8022915677, shared by 11 NPIs, 267 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Middletown, CT
  • NPI 1427074426
  Medicare reassignment NPD
• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Norwich, CT
  • NPI 1902831548
  Medicare reassignment NPD
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679638993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "BLDG 301 SOUTHEASTERN MENTAL HEALTH AUTHORITY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "BLDG 301 SOUTHEASTERN MENTAL HEALTH AUTHORITY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MARY JANE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kilpatrick
• Walter J Kilpatrick III, DO
• Jung Hyun Kim, DDS
• Seul Kim
• Alaina Lyn Kindelan, NP
• Dori Louise Kirby, LCSW
• Kite Counseling
• Lisa Marie Kleckner
• Megan K. Klein, APRN, MS, LS
• Harris L Kleinkopf, D.P.M.

• Clinical Social Worker in Norwich, CT
• Providers in Norwich, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.