Individual provider Active NPI

Kerry Katz, LISW-S

  • Clinical Social Worker
  • Shaker Heights, OH
National Provider Identifier
1003119942
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0010286.SUPV Issued in OH
Practice address
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone
(216) 320-8458
Fax
(216) 932-8520
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0010286.SUPV OH Primary

Addresses

Primary practice location

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Mailing address

2980 Hampton Rd
Cleveland, OH 44120-2746
Phone (216) 316-3612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0010286.SUPVOHMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1003119942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 HAMPTON RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202746",
            "telephone_number": "216-316-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8458",
            "fax_number": "216-932-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "KERRY",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0010286.SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.