Katherine C Shook, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KATHERINE C SHOOK, INC.

Practice address

307 SW 18TH St Ste 3
Bentonville, AR 72712-8478

Phone

(479) 721-1788

NPI assigned

Nov 14, 2023

Organization subpart

No

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

Authorized official

Name

Katherine C Shook, LCSWNPI 1003220906

Title

President

Phone

(479) 721-1788

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Shook, LCSW

  • Clinical Social Worker
  • Jay, OK
  • NPI 1003220906

  AR

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1003680687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "GARFIELD",
            "state": "AR",
            "postal_code": "727320414",
            "telephone_number": "479-721-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 SW 18TH ST STE 3",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128478",
            "telephone_number": "479-721-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE C SHOOK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-12-08",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "SHOOK",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-721-1788",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Kaiser
• Kajsiab Therapy, PLLC
• Kamra Elizabeth Mays, PHD, PLLC
• Elizabeth Kasencak
• Katherine Barton MD, PA
• Katherine Toole DDS PA
• Kathryn M Rinehart DDS PA
• Kati Wells CBT
• Navneet Kaur, M.D.
• Alison Keesaer

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.