Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathleen Ann Potocnik Medina, LCSW

Individual provider Clinical Social Worker · NPI 1629845672

Kathleen Ann Potocnik Medina, LCSW is a Clinical Social Worker in New York, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2023
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

16 Madison Sq W Fl 12
New York, NY 10010-1629
Phone: (917) 562-2921
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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 096567 (NY)

Record details

NPI number1629845672
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 11, 2023
Last updated in NPPESDecember 11, 2023
Certification dateDecember 10, 2023

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