Katrina Shird Clayton, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14844 Issued in MD

Practice address

8600 Lasalle Road
Chester Builing Suite 300
Towon, MD 21286

Phone

(410) 494-9212

Fax

(410) 494-9217

NPI assigned

Sep 7, 2012

Last updated

Dec 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katrina Shird Former name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• King Edwards' Inc.

  • Clinical Social Worker
  • Towson, MD
  • NPI 1275349326
  NPD Authorized official
• King Edwards' Inc.

  dba King Edwards Wellness Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Towson, MD
  • NPI 1417746900
  NPD Authorized official

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1033468806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 LASALLE ROAD",
            "address_2": "CHESTER BUILDING SUITE 300",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-494-9212",
            "fax_number": "410-433-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 LASALLE ROAD",
            "address_2": "CHESTER BUILING SUITE 300",
            "city": "TOWON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-494-9212",
            "fax_number": "410-494-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "KATRINA",
        "middle_name": "SHIRD",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "SHIRD",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.