Active NPI
Kaitlin M McDonnell, LCSW
- Clinical Social Worker
- Pennsburg, PA
National Provider Identifier
1699231571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW023402
- Practice address
- 2012 Berkeley Dr
Pennsburg, PA 18073-1124 - Phone
- (267) 347-3555
- NPI assigned
- Feb 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | CW023402 | PA | Primary |
Addresses
Primary practice location
2012 Berkeley Dr
Pennsburg, PA 18073-1124
Mailing address
2012 Berkeley Dr
Pennsburg, PA 18073-1124
Phone (267) 347-3555
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW023402 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697241600000",
"number": "1699231571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 BERKELEY DR",
"city": "PENNSBURG",
"state": "PA",
"postal_code": "180731124",
"telephone_number": "267-347-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2012 BERKELEY DR",
"city": "PENNSBURG",
"state": "PA",
"postal_code": "180731124",
"telephone_number": "267-347-3555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONNELL",
"first_name": "KAITLIN",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2023-10-14",
"certification_date": "2023-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW023402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pennsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.