Individual provider Active NPI

Kathleen Ann Pinkston

  • Clinical Social Worker
  • Rock Hill, SC
National Provider Identifier
1114519790
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16238 Issued in SC
Practice address
156 Oakland Ave Ste 217
Rock Hill, SC 29730-4485
Phone
(803) 389-2124
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-43826 ID
Clinical Social Worker 1041C0700X C016279 NC
Clinical Social Worker 1041C0700X 16238 SC Primary

Addresses

Primary practice location

156 Oakland Ave Ste 217
Rock Hill, SC 29730-4485

Mailing address

363 Hidden Lake Dr
York, SC 29745-8409
Phone (208) 830-4531

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
LCSW-43826IDMDClinical Social Worker
C016279NCMDClinical Social Worker
16238SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wanderlust Counseling Services, LLC. Clinical CurrentSince Nov 24, 2024 Accepting new patients

Locations

156 Oakland Ave
Ste 217
Rock Hill, SC 29730
Phone (803) 389-2124

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.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1114519790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 HIDDEN LAKE DR",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297458409",
            "telephone_number": "208-830-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 OAKLAND AVE STE 217",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304485",
            "telephone_number": "803-389-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-43826",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016279",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "16238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.