Kathryn Ellsworth Flynn, MSW/LCSW #000317

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000317 Issued in CT

Practice address

107 Church Hill Road
Suite 2a-B
Sandy Hook, CT 06482-1306

Phone

(203) 270-7300

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

No

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1891156519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHURCH HILL ROAD",
            "address_2": "SUITE 2A-B",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821306",
            "telephone_number": "203-270-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CHURCH HILL ROAD",
            "address_2": "SUITE 2A-B",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821306",
            "telephone_number": "203-270-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "KATHRYN",
        "middle_name": "ELLSWORTH",
        "name_prefix": "Ms.",
        "credential": "MSW/LCSW #000317",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kara Noel Fitzgerald, ND
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• William Joseph Fornara, MS COUNSELING
• Lawanda Frederick, LPCA
• Heather Christine Gatesman, FNP
• Gillian Verrastro, LCSW, Ladc, LLC

• All providers in Sandy Hook, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.