Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katherine Bradway Mullis, LCSW

Individual provider Clinical Social Worker · NPI 1619493400

Katherine Bradway Mullis, LCSW is a Clinical Social Worker in Manchester, Connecticut. Qualified in 2015, 11 years ago. Practices with Prospect CT Medical Foundation Inc, a 289-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
11
Licensed in
CT
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

71 Haynes St
Manchester, CT 06040-4131
Phone: (860) 648-6800
Fax: (860) 648-6831
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 009837 (CT)

Record details

NPI number1619493400
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 14, 2017
Last updated in NPPESAugust 14, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Prospect Ct Medical Foundation Inc — 289 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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