Active NPI
Kathleen Ann Shimwell, LCSW
- Mental Health Counselor
- Glastonbury, CT
National Provider Identifier
1740503663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 78 Eastern Blvd
Glastonbury, CT 06033-4325 - Phone
- (860) 218-8387
- NPI assigned
- Mar 5, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CT | Primary |
Addresses
Primary practice location
78 Eastern Blvd
Glastonbury, CT 06033-4325
Mailing address
441 Church St
Wethersfield, CT 06109-2006
Phone (860) 218-8387
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141118000828 | CT | Practitioner - Clinical Social Worker | 0749402212 | Practice locations: Glastonbury, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
78 Eastern Blvd
Glastonbury, CT 06033-4325
Phone (860) 218-8387
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6314 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267747200000",
"number": "1740503663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 CHURCH ST",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061092006",
"telephone_number": "860-218-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 EASTERN BLVD",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060334325",
"telephone_number": "860-218-8387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMWELL",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-05",
"last_updated": "2010-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.