Katherine L Wilson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110067 Issued in MA

Practice address

115 Mill St
Belmont, MA 02478-1041

Phone

(671) 855-3612

NPI assigned

Nov 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

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.

• Children'S Sports Medicine Foundation Inc.

  • Orthopaedic Surgery Physician
  • Boston, MA
  • NPI 1740216811
  Medicare reassignment NPD
• Child and Family Psychological Services, PLLC

  • Psychologist
  • Norwood, MA
  • NPI 1912987181

  Clinical

  NPD
• Spectrum Psychiatric Group PC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Hamden, CT
  • NPI 1518142058
  NPD (past)
• Spectrum Psychiatric Group PC

  • Psychiatry Physician
  • Hamden, CT
  • NPI 1558420653
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1780751396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816202",
            "telephone_number": "671-855-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781041",
            "telephone_number": "671-855-3612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P07826",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Ann Whitney
• James M. Wilkins, MD
• Grace M Williams, LICSW
• William Dustin Willoughby, LMHC
• Julianne Wilner, PH.D.
• James David Wines Jr., MD MPH
• Jaimie Winkler, RD, LDN, CNSD
• Grace Fuzheng Winogradsky, LCSW
• Sherry R Winternitz, M.D.
• Marcia Elizabeth Winters, LMHC

• Clinical Social Worker in Belmont, MA
• Providers in Belmont, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.