Individual provider Active NPI

Katherine A. Saunders, LCSW

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1215357553
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149016543 Issued in IL
Practice address
3837 E Lake Ctr Ste 400
Quincy, IL 62305-5803
Phone
(217) 919-0437
Fax
(217) 241-2790
NPI assigned
Apr 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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 149016543 IL Primary

Addresses

Primary practice location

3837 E Lake Ctr Ste 400
Quincy, IL 62305-5803

Mailing address

3837 E Lake Ctr Ste 400
Quincy, IL 62305-5803
Phone (217) 919-0437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140515000815 IL Practitioner - Clinical Social Worker 4688897887 Reassigns benefits to 1 organization
I20160823001122 MO Practitioner - Clinical Social Worker 4688897887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3837 E Lake Ctr
Suite 400
Quincy, IL 62305-5803
Phone (217) 919-0437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149016543ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Minds Therapy, PLLC Clinical CurrentSince Sep 1, 2023 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

3837 E Lake Ctr
Ste 400
Quincy, IL 62305
Phone (217) 257-6257

1005 Broadway St
Quincy, IL 62301

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1215357553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 E LAKE CTR STE 400",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055803",
            "telephone_number": "217-919-0437",
            "fax_number": "217-241-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3837 E LAKE CTR STE 400",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055803",
            "telephone_number": "217-919-0437",
            "fax_number": "217-241-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "KATHERINE",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.