Individual provider Active NPI

Katie Christina McKay, LCSW

  • Clinical Social Worker
  • Norwalk, CA
National Provider Identifier
1093149064
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
86589 Issued in CA
Practice address
12360 Firestone Blvd
Norwalk, CA 90650-4324
Phone
(562) 867-7999
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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 86589 CA Primary

Addresses

Primary practice location

12360 Firestone Blvd
Norwalk, CA 90650-4324

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other identifiers 1

IdentifierTypeStateIssuer
86589OtherCABOARD OF BEHAVIORAL SCIENCES-DEPARTMENT OF CONSUMER AFFAIRS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86589CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Health Management Psychological Corporation CurrentSince Apr 12, 2021 Accepting new patients
Bloom Behavioral Health Services, LLC Past Accepting new patients

Locations

4110 Edison Ave
Ste 206A
Chino, CA 91710
Phone (951) 454-5577

Interoperability endpoints

  • Direct secure messaging: katie.mckaylcsw.p1@direct.jwch.nextgenshare.com

Organizations & group practices 2

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": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1093149064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "KATIE",
        "middle_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES-DEPARTMENT OF CONSUMER AFFAIRS",
            "identifier": "86589",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.