KATHRYN ELIZABETH FACKINA MA
NPI 1417462169
Counselor - Mental Health in South Boston, MA
About Kathryn Elizabeth Fackina Ma NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHRYN ELIZABETH FACKINA MA (NPI 1417462169) is an individual mental health provider in South Boston, Massachusetts and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kathryn Elizabeth Fackina Ma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kathryn Fackina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
King Of Prussia, PA 19406
- Reassigned Medicare billing, Pennsylvania enrollment
- 14 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH BOSTON, MA 02127
SOUTH BOSTON, MA 02127
SOUTH BOSTON, MA 02127
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kathryn Fackina's NPI number?
The NPI number for Kathryn Fackina is 1417462169. It was assigned to this individual provider in the NPPES registry on December 4, 2017.
Where is Kathryn Fackina located?
Kathryn Fackina practices at 210 Old Colony Ave, South Boston, MA 02127. The listed phone number is (617) 268-5000.
What is Kathryn Fackina's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kathryn Fackina enrolled in Medicare?
Yes. Kathryn Fackina is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kathryn Fackina's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathryn Fackina reassigns Medicare benefits to 2 Crows LLC (King Of Prussia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathryn Fackina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kathryn Fackina was last updated on December 4, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kathryn Elizabeth Fackina, MA · NPI 1417462169
Mental Health provider in South Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since December 4, 2017.
## Identity
- **NPI:** 1417462169 (Entity type: Individual)
- **Enumerated:** December 4, 2017
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 210 OLD COLONY AVE, South Boston, MA 02127-2413
- **Phone:** (617) 268-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 Crows LLC (NPI 1134789662, King Of Prussia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** December 4, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1417462169) · Data from the CMS NPPES public registry.