Kathleen Roach-Seperack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006715 Issued in CT

Practice address

7-9 Isaac St
Norwalk, CT 06850-4102

Phone

(203) 673-9173

NPI assigned

Dec 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pathways to Peace, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, CT
  • NPI 1770240368
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1780155119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 GROVERS AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053452",
            "telephone_number": "203-673-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7-9 ISAAC ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068504102",
            "telephone_number": "203-673-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH-SEPERACK",
        "first_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissette Rivas Siracusa, APRN
• Jose Enrique Rivas, MD
• Nellie Esther Rivera, LCSW
• Riverview Emergency Services LLC
• Anthony Riviello, PHARMD
• Luke Thomas Robbins, LCSW
• Lea Roberson, PHARM.D.
• Robert L. Weiss, MD, PC
• Danielle Roberts, MD
• Genevieve Marie Robinson

• Clinical Social Worker in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.

Verify at the official NPI Registry.