Kathleen Licata Dodge

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

RN191969 Issued in MA

Practice address

67 Crocker Ave
Turners Falls, MA 01376-1925

Phone

(413) 388-1952

NPI assigned

Aug 18, 2021

Last updated

Aug 18, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1831865955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 CROCKER AVE",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013761925",
            "telephone_number": "413-388-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CROCKER AVE",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013761925",
            "telephone_number": "413-388-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "KATHLEEN",
        "middle_name": "LICATA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "RN191969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Cohen, DMD
• Jeffrey Michael Collura, DMD
• Community Health Center of Franklin County Incorporated
• Connecticut River Internists, LLP
• Daniel Cohen, DMD, PC
• Garry L. Earles, M.S.W., L.I.C.S.W.
• Islam Eldib, LLD
• Farren Care Center, Inc.
• Colleen Yvonne Ferris
• Paul Stradley Flandreau, M.D., M.ED.

• Addiction (Substance Use Disorder) Registered Nurse in Turners Falls, MA
• Providers in Turners Falls, MA by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.