Individual provider Active NPI

Katelyn Carlburg, LCSW

  • Clinical Social Worker
  • Kingsport, TN
National Provider Identifier
1053216564
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10576 Issued in TN
Practice address
2971 Fort Henry Dr
Kingsport, TN 37664-4005
Phone
(423) 392-2975
NPI assigned
Oct 13, 2026
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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 10576 TN Primary

Addresses

Primary practice location

2971 Fort Henry Dr
Kingsport, TN 37664-4005

Mailing address

2971 Fort Henry Dr
Kingsport, TN 37664-4005
Phone (423) 392-2975

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1791849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1053216564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-392-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-392-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLBURG",
        "first_name": "KATELYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-13",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "10576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.