Individual provider Active NPI

Katherine Coughlin, LMSW

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1689381154
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
105 Hamilton Ave
Staten Island, NY 10301-1610
Phone
(718) 764-2410
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

105 Hamilton Ave
Staten Island, NY 10301-1610

Mailing address

117 W 124TH St FL 6
New York, NY 10027-4920
Phone (917) 816-8841

Other identifiers 1

IdentifierTypeStateIssuer
15753217OtherNYCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Aid Society CurrentSince Nov 6, 2022 Accepting new patients
The Children's Aid Society CurrentSince Nov 6, 2022 Accepting new patients
The Children's Aid Society PastSince Nov 6, 2022 Accepting new patients

Locations

117 W 124th St
Fl 6
New York, NY 10027

105 Hamilton Ave
Staten Island, NY 10301
Phone (718) 764-2410

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1689381154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 124TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920",
            "telephone_number": "917-816-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HAMILTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011610",
            "telephone_number": "718-764-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15753217",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.