Individual provider Active NPI

Kathryn Anne Chapman, MSW LICSW

  • Clinical Social Worker
  • Tyngsboro, MA
National Provider Identifier
1821159344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106234 Issued in MA
Practice address
6 Pondview Place
Tyngsboro, MA 01879
Phone
(978) 649-9980
Fax
(978) 649-9127
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 106234 MA Primary
Clinical Social Worker 1041C0700X 678 NH

Addresses

Primary practice location

6 Pondview Place
Tyngsboro, MA 01879

Mailing address

1454 Mystic Valley Parkway
Medford, MA 02155
Phone (781) 488-3242

Other identifiers 2

IdentifierTypeStateIssuer
1891715OtherMASS HEALTH
30421453MedicaidNH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120110000194 MA Practitioner - Clinical Social Worker 2769387687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1454 Mystic Valley Pkwy
Medford, MA 02155-6803
Phone (978) 649-9980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
678NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Counseling LLC Clinical CurrentSince Jan 1, 2020 Accepting new patients

Locations

5 Pondview Pl
Tyngsboro, MA 01879
Phone (978) 649-9980

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821159344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MYSTIC VALLEY PARKWAY",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-488-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PONDVIEW PLACE",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "01879",
            "telephone_number": "978-649-9980",
            "fax_number": "978-649-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106234",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "678",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "1891715",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421453",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyngsboro, MA

Sources for this page

Verify at the official NPI Registry.