Individual provider Active NPI

Kathleen Gray Chaney, LGSW

  • Clinical Social Worker
  • Bridgeport, WV
National Provider Identifier
1841856739
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00945187 Issued in WV
Practice address
65 Professional PL Ste And103
Bridgeport, WV 26330-0258
Phone
(304) 848-5770
Fax
(304) 848-0890
NPI assigned
May 15, 2019
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X DP00945187 WV Primary

Addresses

Primary practice location

65 Professional PL Ste And103
Bridgeport, WV 26330-0258

Mailing address

65 Professional PL Ste And103
Bridgeport, WV 26330-0258
Phone (304) 848-5770

Other identifiers 1

IdentifierTypeStateIssuer
SW061714331OtherWVSOCIAL WORK LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20220210002960 WV Practitioner - Clinical Social Worker 8820481013 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00945187WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of West Virginia, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

100 Market Pl
Bridgeport, WV 26330
Phone (304) 644-8866

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1841856739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE AND103",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300258",
            "telephone_number": "304-848-5770",
            "fax_number": "304-848-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE AND103",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300258",
            "telephone_number": "304-848-5770",
            "fax_number": "304-848-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "KATHLEEN",
        "middle_name": "GRAY",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00945187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "SW061714331",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.