Katie Community Health Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2003003711 Issued in MO

Legal business name

KATIE COMMUNITY HEALTH CENTER, LLC

Practice address

143 Mill Street
Raymondville, MO 65555

Phone

(417) 299-0753

NPI assigned

May 5, 2010

Last updated

May 5, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia Dewitt, LCSW

Title

Owner

Phone

(417) 299-0753

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard D Reynolds, MSW, LCSW

  • Clinical Social Worker
  • Raymondville, MO
  • NPI 1518285402
  NPD (past)

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1295053957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S NEWTON AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658062742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 MILL STREET",
            "city": "RAYMONDVILLE",
            "state": "MO",
            "postal_code": "65555",
            "telephone_number": "417-299-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATIE COMMUNITY HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-299-0753",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2003003711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard D Reynolds, MSW, LCSW

• Clinical Social Worker in Raymondville, MO
• Providers in Raymondville, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.