Active NPI
Rebecca Bennett Katovsich, PHD, LLP, LMSW
- Clinical Social Worker
- Saint Joseph, MI
National Provider Identifier
1063512671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801080778
- Practice address
- 903 Main St
Saint Joseph, MI 49085-1426 - Phone
- (269) 985-2000
- Fax
- (269) 985-2002
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801080778 | MI | |
| Clinical Psychologist | 103TC0700X | 6301013818 | MI | |
| Clinical Social Worker | 1041C0700X | 6801080778 | MI | Primary |
| Psychologist | 103T00000X | 6301013818 | MI |
Addresses
Primary practice location
903 Main St
Saint Joseph, MI 49085-1426
Mailing address
903 Main St
Saint Joseph, MI 49085-1426
Phone (269) 985-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RK080778 | Other | MI | BLUE CROSS BLUE SHIELD |
| 8008979580 | Other | MI | BCBS |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301013818 | MI | MD | Clinical Psychologist |
| 6801080778 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepard House Counseling & Psychological Services, P.C. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counseling Psychologist
- Saint Joseph, MI
- NPI 1205977527
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234483200000",
"number": "1063512671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 MAIN ST",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490851426",
"telephone_number": "269-985-2000",
"fax_number": "269-985-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 MAIN ST",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490851426",
"telephone_number": "269-985-2000",
"fax_number": "269-985-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATOVSICH",
"first_name": "REBECCA",
"middle_name": "BENNETT",
"name_prefix": "Dr.",
"credential": "PHD, LLP, LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2009-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801080778",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301013818",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801080778",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301013818",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "RK080778",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8008979580",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.