Active NPI
Kaelin A Large, MSW
- Social Worker
- Memphis, TN
National Provider Identifier
1124513460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 560 Colonial Rd Ste 201
Memphis, TN 38117-4097 - Phone
- (901) 930-7397
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
560 Colonial Rd Ste 201
Memphis, TN 38117-4097
Mailing address
560 Colonial Rd
Memphis, TN 38117-4019
Phone (901) 930-7397
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forward Counseling, PLC | Multi-Specialty | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530144000000",
"number": "1124513460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 COLONIAL RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174019",
"telephone_number": "901-930-7397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 COLONIAL RD STE 201",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174097",
"telephone_number": "901-930-7397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARGE",
"first_name": "KAELIN",
"middle_name": "A",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-28",
"last_updated": "2018-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.