Active NPI
Katherine S. Wasserman, LICSW
- Clinical Social Worker
- Somerville, MA
National Provider Identifier
1801810882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1016668
- Practice address
- 40 Holland St
Somerville, MA 02144-2705 - Phone
- (617) 629-6180
- NPI assigned
- Jul 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1016668 | MA | Primary |
Addresses
Primary practice location
40 Holland St
Somerville, MA 02144-2705
Mailing address
147 Milk St
Provider Enrollment 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8051
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P07593 | Other | MA | BLUE CROSS |
| 669498 | Other | MA | TUFTS HEALTH PLAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1016668 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239321600000",
"number": "1801810882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-559-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442705",
"telephone_number": "617-629-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "KATHERINE",
"middle_name": "S.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2009-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1016668",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "P07593",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "669498",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.