Kaileah Christie-Fogg, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8828 Issued in CT

Practice address

481 Gold Star Hwy
301
Groton, CT 06340-6702

Phone

(860) 287-6393

NPI assigned

Dec 14, 2012

Last updated

Aug 16, 2016By the provider in NPPES

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 names 1

• Kaileah Christie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kaileah Christie-Fogg, LLC

  • Clinical Social Worker
  • Groton, CT
  • NPI 1780057653
  NPD (past) Authorized official

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1972849289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 GOLD STAR HWY",
            "address_2": "301",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406702",
            "telephone_number": "860-287-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 GOLD STAR HWY",
            "address_2": "301",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406702",
            "telephone_number": "860-287-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE-FOGG",
        "first_name": "KAILEAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "8828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEAH",
            "last_name": "CHRISTIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Child and Family Agency of Southeastern Connecticut, Inc. (Grasso Technical High School)
• Child and Family Agency of Southeastern Connecticut, Inc. (Catherine Kolnaski Steam Magnet School)
• Child and Family Agency of Southeastern Connecticut, Inc.
• Kajonwud Shane Chongulia, DMD
• Christian Counseling Center of SE CT, Inc.
• Corie Citron
• Claim Path Connecticut, LLC
• Ariel Lyn Clark, PHARMD
• Patrick Joseph Clayton
• Nicholas Andrew Clear

• Social Worker in Groton, CT
• Providers in Groton, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.