Active NPI
Kathleen Marie McNulty, LCSW C LICSW
- Clinical Social Worker
- Bethesda, MD
National Provider Identifier
1740400928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10780
- Practice address
- 4848 Battery Lane
Suite 202
Bethesda, MD 20814 - Phone
- (301) 717-1155
- Fax
- (301) 654-4742
- NPI assigned
- Apr 27, 2007
- Last updated
- Jul 8, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10780 | MD | Primary |
| Clinical Social Worker | 1041C0700X | LC303469 | DC | |
| Clinical Social Worker | 1041C0700X | 049706 | NY |
Addresses
Primary practice location
4848 Battery Lane
Suite 202
Bethesda, MD 20814
Mailing address
4938 Hampden Lane
#199
Bethesda, MD 20814
Phone (301) 717-1155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049706 | NY | MD | Physical Therapist |
| 10780 | MD | MD | Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bethesda, MD
- NPI 1689105447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740400928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4938 HAMPDEN LANE",
"address_2": "#199",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20814",
"telephone_number": "301-717-1155",
"fax_number": "301-654-4742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4848 BATTERY LANE",
"address_2": "SUITE 202",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20814",
"telephone_number": "301-717-1155",
"fax_number": "301-654-4742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNULTY",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW C LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "10780",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC303469",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "049706",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.