MS. KAITLYN MARIE FENNER (MWS) – Social Worker, NPI 1639504202

MS. KAITLYN MARIE FENNER (MWS) is a healthcare provider. based in Vernon, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MWS. The NPI Number for MS. KAITLYN MARIE FENNER (MWS) is 1639504202

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MS. KAITLYN MARIE FENNER (MWS)
NPI
1639504202
Phone
(860) 614-4777
Address
12 PHOENIX ST
Enumeration Date
13 September 2013
Last Update Date
13 September 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037721270
Graduation Year
2023 (3 years ago)
PAC ID
0042672172
Group Practice PAC ID
1951771054
Professional Enrollment ID
I20230821004116
Address ID
CT065113933NE93XXXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness75
Years active:12State licenses:0Digital endpointsOther names

2,151 CLINICAL SOCIAL WORKER in CT

Provider Addresses for MS. KAITLYN MARIE FENNER (MWS)

  • 12 PHOENIX ST

    VERNON, CT 060665416

    Phone: (860) 614-4777

    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: 2023-08-21

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
I20230821004116IClinical 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 06066)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951771054View full group profile
NameSpecialtyState
Nurse PractitionerCT
Clinical Social WorkerCT
Marriage And Family TherapistCT
P S Y C H I A T R YCT
Clinical PsychologistCT
Mental Health CounselorCT
Mental Health CounselorCT
Clinical Social WorkerCT
Clinical PsychologistCT
Nurse PractitionerCT

Reviews

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Frequently asked questions

What unique ID ties claims to MS. KAITLYN MARIE FENNER (MWS)?
NPI 1639504202 is assigned to MS. KAITLYN MARIE FENNER (MWS) under the national enumeration system.
Is MS. KAITLYN MARIE FENNER (MWS)'s NPI currently valid?
The extract we use shows MS. KAITLYN MARIE FENNER (MWS) as active.
What kind of provider is MS. KAITLYN MARIE FENNER (MWS)?
The page reflects Social Worker for MS. KAITLYN MARIE FENNER (MWS). Clinical services aligned with this taxonomy classification.
What location metadata exists for MS. KAITLYN MARIE FENNER (MWS)?
The page summarizes Vernon, Connecticut for MS. KAITLYN MARIE FENNER (MWS); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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