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

Individual provider Social Worker · NPI 1922435676

Malyna Kettavong, LCSW is a Clinical Social Worker in Norwich, Connecticut. Qualified in 2012, 14 years ago. Practices with Windham Community Memorial Hospital Inc, a 64-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.

Years since qualifying
14
Licensed in
CT
In the registry since
2013
Specialties on file
2
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

47 Town St
Norwich, CT 06360-2315
Phone: (860) 892-7042
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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 8972 (CT)
Social Worker Taxonomy 104100000X

Record details

NPI number1922435676
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 26, 2013
Last updated in NPPESAugust 5, 2016

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Windham Community Memorial Hospital Inc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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