Active NPI
Katheryn Lane McDonough, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1275947681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 106420
- Practice address
- 4470 W Sunset Blvd Ste 107
Los Angeles, CA 90027-6309 - Phone
- (707) 502-2577
- NPI assigned
- Jun 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 106420 | CA | Primary |
Addresses
Primary practice location
4470 W Sunset Blvd Ste 107
Los Angeles, CA 90027-6309
Mailing address
PO Box 6829
Eureka, CA 95502-6829
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106420 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tehama County | 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.
-
- Community/Behavioral Health Agency
- Red Bluff, CA
- NPI 1982810107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1275947681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6829",
"city": "EUREKA",
"state": "CA",
"postal_code": "955026829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4470 W SUNSET BLVD STE 107",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276309",
"telephone_number": "707-502-2577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "KATHERYN",
"middle_name": "LANE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-13",
"last_updated": "2023-02-27",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "106420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.