Active NPI
Kathryn Johnson, LICSW
- Clinical Social Worker
- Amesbury, MA
National Provider Identifier
1710469101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 115187
- Practice address
- 5 Market SQ Ste 109
Amesbury, MA 01913-2440 - Phone
- (978) 834-9710
- NPI assigned
- Aug 31, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 115187 | MA | Primary |
Addresses
Primary practice location
5 Market SQ Ste 109
Amesbury, MA 01913-2440
Mailing address
5 Market SQ Ste 109
Amesbury, MA 01913-2440
Phone (978) 834-9710
Other names 1
- Kathryn Liddy
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 |
|---|---|---|---|
| 115187 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535673600000",
"number": "1710469101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 MARKET SQ STE 109",
"city": "AMESBURY",
"state": "MA",
"postal_code": "019132440",
"telephone_number": "978-834-9710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 MARKET SQ STE 109",
"city": "AMESBURY",
"state": "MA",
"postal_code": "019132440",
"telephone_number": "978-834-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KATHRYN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-31",
"last_updated": "2018-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "115187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "LIDDY",
"credential": "LICSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Amesbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.