Individual provider Active NPI

Kateri Kerwin, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1104311265
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00992673 Issued in CO
Practice address
1287 Lake Plaza Dr
Colorado Springs, CO 80906-3553
Phone
(719) 227-7190
Fax
(719) 576-1500
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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 00992673 CO Primary

Addresses

Primary practice location

1287 Lake Plaza Dr
Colorado Springs, CO 80906-3553

Mailing address

1287 Lake Plaza Dr
Colorado Springs, CO 80906-3553
Phone (719) 227-9170

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

State licenses

LicenseStateTypeSpecialty
00992673COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1104311265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063553",
            "telephone_number": "719-227-9170",
            "fax_number": "719-576-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063553",
            "telephone_number": "719-227-7190",
            "fax_number": "719-576-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERWIN",
        "first_name": "KATERI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "00992673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.