KATHLEEN WATANABE (NPI# 1518079730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518079730 |
| Entity Type | Individual |
| Full Name | KATHLEEN WATANABE |
| Credential | LCSW LADC |
| Practice Address |
154 College St Middletown CT 06457 |
| Practice Telephone | 8603478894 |
| Practice Fax Number | 8603462405 |
| Mailing Telephone | 8603478894 |
| Mailing Fax Number | 8603462405 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
00039 | CT | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
004228 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM | 140004228CT01 | 01 |
| Street Address |
154 COLLEGE ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982626438 | David Spalding | Social Worker | 154 College St, Middletown, CT 06457-3201 | 2006-07-24 |
| 1205303112 | Edward George Langford II | Counselor | 154 College St, Middletown, CT 06457-3201 | 2018-10-29 |
| 1093089948 | College Street Counseling Center LLC | Counselor | 154 College St, Middletown, CT 06457-3201 | 2012-02-23 |
| 1275685331 | Sally F Baumer | Social Worker | 154 College St, Middletown, CT 06457-3201 | 2007-01-17 |
| 1366593477 | Patrick Joseph Russolillo | Psychologist | 154 College St, Middletown, CT 06457-3201 | 2007-01-15 |
| 1477603876 | Phillip Sylvester | Psychologist | 154 College St, Middletown, CT 06457-3201 | 2007-01-11 |
| 1821155391 | Mark Emanuel Kaplan | Psychologist | 154 College St, Middletown, CT 06457-3201 | 2007-01-03 |
| 1821166802 | Rosemary Bleyer | Psychologist | 154 College St, Middletown, CT 06457-3201 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443185 | Pursuecare Connecticut PC | Counselor | 101 Centerpoint Dr Ste 105, Middletown, CT 06457-7568 | 2020-03-26 |
| 1568020584 | Rashidah Cartwright | Counselor | 223 Wilson Ave, Middletown, NJ 07748-1528 | 2019-06-04 |
| 1962068296 | Pursuecare, LLC | Counselor | 101 Centerpoint Dr Ste 221, Middletown, CT 06457-7568 | 2019-05-13 |
| 1962978759 | Stephani Chandra Miller | Counselor | 160 N. Breiel Blvd, Middletown, OH 45042 | 2018-10-18 |
| 1649764549 | Hilarie Baron | Counselor | 26 Valley Rd Ste 202, Middletown, RI 02842-6371 | 2018-06-15 |
| 1700379773 | Starting Point of Kentucky, Psc | Counselor | 12610 Townepark Way, Middletown, KY 40243-2068 | 2018-06-13 |
| 1770076200 | Kimberly Sue Ross | Counselor | 2005 Central Ave, Middletown, OH 45044-4403 | 2018-06-09 |
| 1669964227 | Ashley Loren Witt | Counselor | 2005 Central Avenue, Middletown, OH 45044 | 2018-05-30 |
| 1831616242 | Shantha Angela Worley | Counselor | 2 Fortune Rd E, Middletown, NY 10941-1633 | 2017-08-25 |
| 1780082149 | Loretta Verderosa | Counselor | 426 Third Beach Rd, Middletown, RI 02842-5739 | 2014-12-16 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on KATHLEEN WATANABE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.