Individual provider Active NPI

Kathryn Souder, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1073144325
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW019315 Issued in PA
Practice address
3535 Market St FL 2
Philadelphia, PA 19104-3317
Phone
(215) 746-6701
Fax
(215) 756-7350
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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 CW019315 PA Primary

Addresses

Primary practice location

3535 Market St FL 2
Philadelphia, PA 19104-3317

Mailing address

3535 Market St FL 2
Philadelphia, PA 19104-3317
Phone (215) 746-6701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20200804003787 PA Practitioner - Clinical Social Worker 6103256243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3535 Market St
FL 2
Philadelphia, PA 19104-3317
Phone (215) 746-6701

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW019315PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Apr 17, 2022 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Apr 17, 2022 Accepting new patients
Springfield Psychological PC CurrentSince Jul 30, 2020 Accepting new patients

Locations

3535 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2816

1420 Walnut St
Ste 1500
Philadelphia, PA 19102
Phone (610) 544-2100

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1073144325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043317",
            "telephone_number": "215-746-6701",
            "fax_number": "215-756-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043317",
            "telephone_number": "215-746-6701",
            "fax_number": "215-756-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDER",
        "first_name": "KATHRYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.