KIM SHEPARDSON WATSON LCSW
NPI 1164534384
Social Worker in East Lyme, CT

Q: What is Kim Shepardson Watson's NPI number?

The NPI number for Kim Shepardson Watson is 1164534384. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is Kim Shepardson Watson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Active since September 01, 2006PECOS EnrolledAccepts Medicare Assignment

29 CHESTERFIELD RD, EAST LYME, CT 06333(860) 739-6974(860) 739-5290 Get Directions Write a Review

NPPES record last updated: September 12, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kim Shepardson Watson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM SHEPARDSON WATSON LCSW (NPI 1164534384) is an individual social worker in East Lyme, Connecticut, licensed in Connecticut (002624) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1989).

NPPES Registry Identity

NPI1164534384

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameKIM SHEPARDSON WATSONCredential: LCSW

Location Address29 CHESTERFIELD RDEast Lyme, CT 06333

Mailing AddressPo Box 94East Lyme, CT 06333 · (860) 739-6974 · Fax (860) 739-5290

Phone(860) 739-6974

Fax(860) 739-5290

Sole ProprietorYes

Medical School CMSOtherGraduated 1989

Enumeration DateSeptember 1, 2006

Last NPPES UpdateSeptember 12, 2011

✔ NPI 1164534384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in CT · 002624

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

29 CHESTERFIELD RD, East Lyme, CT 06333

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Other Identifiers 2

Medicare ID-Type Unspecified800003128CT

Medicaid004255875CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kim Shepardson Watson Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072789445

PECOS Enrollment IDI20120106000106

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DONALD W MCINTYRE PHD

Psychologist (Clinical)

29 CHESTERFIELD RD
EAST LYME, CT 06333