Active NPI
Kim McNamara, LICSW
- Mental Health Counselor
- Winchester, MA
National Provider Identifier
1972641405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1024296
- Practice address
- 540 Main St
Suite 17
Winchester, MA 01890-2940 - Phone
- (617) 331-3314
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1024296 | MA | Primary |
Addresses
Primary practice location
540 Main St
Suite 17
Winchester, MA 01890-2940
Mailing address
540 Main St
Suite 17
Winchester, MA 01890-2940
Phone (617) 331-3314
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1890794 | Medicaid | MA | |
| 206370 | Other | MA | TUFTS HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 10, 2022 through Sep 10, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1972641405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 MAIN ST",
"address_2": "SUITE 17",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018902940",
"telephone_number": "617-331-3314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 MAIN ST",
"address_2": "SUITE 17",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018902940",
"telephone_number": "617-331-3314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNAMARA",
"first_name": "KIM",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "1024296",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1890794",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH CARE",
"identifier": "206370",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.