Kathleen J Dezenzo, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106680 Issued in MA

Practice address

31 Hall Dr
Amherst Medical Center
Amherst, MA 01002-2751

Phone

(413) 256-8561

Fax

(413) 256-4412

NPI assigned

Nov 30, 2005

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

Other identifiers 6

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

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1952385395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HALL DR",
            "address_2": "STE 1",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022778",
            "telephone_number": "866-431-4077",
            "fax_number": "413-774-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HALL DR",
            "address_2": "AMHERST MEDICAL CENTER",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022751",
            "telephone_number": "413-256-8561",
            "fax_number": "413-256-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZENZO",
        "first_name": "KATHLEEN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P04647",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1293395",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US/HEALTHCARE",
            "identifier": "7337314",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2072422",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "106680",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "28435",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Michaela Deangelis, MA
• Gabrielle Deboise-Henrichon
• Stephanie Deleon, LICSW
• Kathryn Erin Dempsey, PA
• Frank Joseph Dezenzo, LICSW
• Jyotika Dhawan
• Andrea Ange Dibenedetto, ED.D.
• Pooja Dipanker
• Amanda M Distasio, PH.D.
• Katherine Lee Dixon-Gordon, PH.D.

• Clinical Social Worker in Amherst, MA
• Providers in Amherst, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.