KATHARINE SMITH-VAUGHAN (LICSW) – Clinical Social Worker, NPI 1174987051

KATHARINE SMITH-VAUGHAN (LICSW) is a healthcare provider. based in Lynn, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 118695 (MA). The NPI Number for KATHARINE SMITH-VAUGHAN (LICSW) is 1174987051

Main info

Female
Sole Proprietor
14 Years Of Experience
Name
KATHARINE SMITH-VAUGHAN (LICSW)
NPI
1174987051
Phone
(978) 882-2764
Address
4 TIMSBURY TER
Enumeration Date
7 April 2016
Last Update Date
7 April 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9787041212
Graduation Year
2012 (14 years ago)
PAC ID
3274074125
Group Practice PAC ID
7012328461
Professional Enrollment ID
I20240919001690
Address ID
MA019382345IP4XXXXSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

4,246 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for KATHARINE SMITH-VAUGHAN (LICSW)

  • 4;6, Timsbury Terrace, Lynn, Essex County, Massachusetts, 01902, United States

    LYNN, MA 019023217

    Phone: (978) 882-2764

    Type: Location

  • Urology Consultants of the North Shore, 400, Highland Avenue, Salem, Essex County, Massachusetts, 01970, United States

    SUITE 1

    SALEM, MA 019707003

    Phone: (978) 741-9585

    Fax: (978) 741-3927

    Type: Mailing

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: 2024-09-19

PECOS data refreshed: 2026-06-15

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
I20240919001690IClinical Social WorkerMATBD

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 01902)

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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: 7012328461View full group profile
NameSpecialtyState
Clinical Social WorkerMA
Clinical Social WorkerMA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KATHARINE SMITH-VAUGHAN (LICSW)?
KATHARINE SMITH-VAUGHAN (LICSW) — NPI 1174987051 — is the standard way to identify this listing.
Does the file indicate KATHARINE SMITH-VAUGHAN (LICSW) is practicing under active NPI?
Directory data currently reports KATHARINE SMITH-VAUGHAN (LICSW) as active.
What healthcare role does KATHARINE SMITH-VAUGHAN (LICSW) hold?
Scheduling teams often label KATHARINE SMITH-VAUGHAN (LICSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where should I expect KATHARINE SMITH-VAUGHAN (LICSW) on a map?
Expect Lynn, Massachusetts as a primary anchor for KATHARINE SMITH-VAUGHAN (LICSW) unless the record lists multiple sites.
Is the information about KATHARINE SMITH-VAUGHAN (LICSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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