Katrina Jefferson, M.S.W., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CP00940811 Issued in WV

Practice address

5930 Mahood Dr
Huntington, WV 25705-2210

Phone

(304) 634-0274

Fax

(304) 736-6677

NPI assigned

Mar 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Katrina M. Jefferson

  • Specialist
  • Huntington, WV
  • NPI 1801253539
  NPD (past) Authorized official

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1295059970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "ONA",
            "state": "WV",
            "postal_code": "255450307",
            "telephone_number": "304-634-0274",
            "fax_number": "304-736-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 MAHOOD DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052210",
            "telephone_number": "304-634-0274",
            "fax_number": "304-736-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "KATRINA",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "CP00940811",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "CP00940811",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WV",
            "license": "CP00940811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Sahan Jayasuriya, MD
• Dylan Dileepa Jayasuriya, MD
• Madison F Jeffers
• Stephanie Jeffers, LSW
• Bonita Jo Jefferson, MA/SLP
• Perri Jefferson
• Jeffrey E Shook DPM PLLC
• Bruce E Jeffreys
• Abrianna Jeffries
• Faith Ann Jenelos, MS, RD, LD

• Clinical Social Worker in Huntington, WV
• Providers in Huntington, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.