Individual provider Active NPI

Kathrine Lynn Clarke, LMFT

  • Marriage & Family Therapist
  • Mystic, CT
National Provider Identifier
1821156589
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001298 Issued in CT
Practice address
34 Water St Ste 2B
Mystic, CT 06355-2524
Phone
(860) 405-4855
NPI assigned
Dec 5, 2006
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001298 CT Primary

Addresses

Primary practice location

34 Water St Ste 2B
Mystic, CT 06355-2524

Mailing address

4 Quail Meadow Mane
Gales Ferry, CT 06335
Phone (860) 405-4844

Other practice location 1

47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042

Other names 1

  • Kathrine Kennedy Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001298CTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1821156589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 QUAIL MEADOW MANE",
            "city": "GALES FERRY",
            "state": "CT",
            "postal_code": "06335",
            "telephone_number": "860-405-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WATER ST STE 2B",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552524",
            "telephone_number": "860-405-4855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Town St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602315",
            "country_code": "US",
            "telephone_number": "860-892-7042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KATHRINE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRINE",
            "last_name": "KENNEDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mystic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.