Individual provider Active NPI

Catherine Douglas, LSW

  • Social Worker
  • Kingston, PA
National Provider Identifier
1982257887
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW129457 Issued in PA
Practice address
189 Market St
Kingston, PA 18704-5400
Phone
(570) 961-3361
Fax
(570) 961-3364
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW129457 PA Primary

Addresses

Primary practice location

189 Market St
Kingston, PA 18704-5400

Mailing address

4101 Birney Ave
Moosic, PA 18507-1323
Phone (570) 961-3361

Other names 1

  • Catherine Smith Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW129457PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John G Kuna Psy D & Associates LLC CurrentSince Jul 25, 2019 Accepting new patients

Locations

189 Market St
Kingston, PA 18704
Phone (570) 288-6220

4101 Birney Ave
Moosic, PA 18507
Phone (507) 961-3361

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1982257887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 BIRNEY AVE",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071323",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 MARKET ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045400",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CATHERINE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW129457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "SMITH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.