NPIMap

Individual provider Active NPI

Kathy Schutz, LCSW

  • Clinical Social Worker
  • Greenville, NC
National Provider Identifier
1033241419
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO5392 Issued in NC
Practice address
702 Cromwell Dr
Suite G
Greenville, NC 27858-5436
Phone
(252) 714-1755
NPI assigned
Mar 12, 2007
Last updated
Apr 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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 COO5392 NC Primary

Addresses

Primary practice location

702 Cromwell Dr
Suite G
Greenville, NC 27858-5436

Mailing address

3709 Barton Way
Grimesland, NC 27837-9159
Phone (252) 714-1755

Other identifiers 1

IdentifierTypeStateIssuer
6106507MedicaidNC

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
COO5392NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kathy Schutz LCSW PC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1033241419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 BARTON WAY",
            "city": "GRIMESLAND",
            "state": "NC",
            "postal_code": "278379159",
            "telephone_number": "252-714-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 CROMWELL DR",
            "address_2": "SUITE G",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585436",
            "telephone_number": "252-714-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUTZ",
        "first_name": "KATHY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO5392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106507",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.