MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) – Clinical Social Worker, NPI 1023027414

MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) is a healthcare provider. based in Racine, Wisconsin. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials L.C.S.W.. They hold a License No. 7210-123 (WI). The NPI Number for MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) is 1023027414

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.)
NPI
1023027414
Phone
(262) 633-3591
Address
1220 MOUND AVE
Enumeration Date
5 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4143025400
Graduation Year
2001 (25 years ago)
PAC ID
0648305276
Group Practice PAC ID
8628980943
Professional Enrollment ID
I20100320000258
Address ID
WI530052441BR13950DRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,447 CLINICAL SOCIAL WORKER in WI

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Provider Addresses for MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.)

  • 21st Century Preparatory School, 1220, Mound Avenue, Racine, Wisconsin, 53404, United States

    SUITE 301

    RACINE, WI 534043350

    Phone: (262) 633-3591

    Fax: (262) 633-2619

    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: 2010-03-20

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
I20100320000258IClinical Social WorkerWITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes14512$0
View full utilization report →

Insurance plans in this area (ZIP 53404)

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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: 8628980943View full group profile
NameSpecialtyState
-WI
Mental Health CounselorWI
-WI
Internal MedicineWI
Hospitalist, Internal MedicineWI
U R O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YWI
-OH
-WI
-WI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.)?
MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) — NPI 1023027414 — is the standard way to identify this listing.
Is MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) still practicing?
MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) is currently listed as active in the public NPI registry.
What healthcare role does MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) hold?
Scheduling teams often label MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What area does MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) serve?
MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.)'s listing highlights Racine, Wisconsin; more addresses can appear in NPPES.
Why does MRS. KATHLEEN FENNO MCNULTY (L.C.S.W.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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