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KIM SHEPARDSON WATSON LCSW NPI 1164534384


NPI Information

NPI: 1164534384
Provider Name: KIM SHEPARDSON WATSON, LCSW
Classification: Social Worker - 104100000X
Entity Type: Individual

PECOS Registration: Yes

Address:
29 CHESTERFIELD RD
EAST LYME, CT
ZIP 06333
Phone: (860) 739-6974
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Kim Shepardson Watson, LCSW is a social worker in East Lyme, CT with 35 years of experience. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Kim Shepardson Watson, LCSW NPI is 1164534384. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

29 CHESTERFIELD RD
EAST LYME, CT
ZIP 06333
Phone: (860) 739-6974
Fax: (860) 739-5290

The NPI 1164534384 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 9/1/2006 and was last updated on 9/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1104100000XSocial Worker002624CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1800003128MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUT
2004255875MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.