KATHLEEN WATANABE (LCSW LADC) – Addiction (Substance Use Disorder) Counselor, NPI 1518079730

KATHLEEN WATANABE (LCSW LADC) is a healthcare provider. based in Middletown, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW LADC. They hold a License No. 00039 (CT). The NPI Number for KATHLEEN WATANABE (LCSW LADC) is 1518079730

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN WATANABE (LCSW LADC)
NPI
1518079730
Phone
(860) 347-8894
Address
154 COLLEGE ST
Enumeration Date
1 September 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8603478894
Graduation Year
1995 (31 years ago)
PAC ID
0042486813
Professional Enrollment ID
I20111228000296
Address ID
CT064573201MI154XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:19State licenses:2Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

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Provider Addresses for KATHLEEN WATANABE (LCSW LADC)

  • 154, College Street, South Farms, Middletown, Middlesex County, Connecticut, 06457, United States

    MIDDLETOWN, CT 06457

    Phone: (860) 347-8894

    Fax: (860) 346-2405

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-12-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111228000296IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06457)

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Reviews

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Frequently asked questions

How is KATHLEEN WATANABE (LCSW LADC) identified in CMS data?
CMS-hosted NPPES data lists KATHLEEN WATANABE (LCSW LADC) with NPI 1518079730.
Is KATHLEEN WATANABE (LCSW LADC) listed as active for patients and plans?
The listing shows KATHLEEN WATANABE (LCSW LADC) as active in the NPI system.
What healthcare role does KATHLEEN WATANABE (LCSW LADC) hold?
Scheduling teams often label KATHLEEN WATANABE (LCSW LADC) under Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.
Does KATHLEEN WATANABE (LCSW LADC) list a practice location?
Patients near Middletown, Connecticut may find KATHLEEN WATANABE (LCSW LADC) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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