Individual provider Active NPI

Katherine CHI, LCSW122142, PPSC

  • Clinical Social Worker
  • Redwood City, CA
National Provider Identifier
1316514748
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW122142 Issued in CA
Practice address
647 Veterans Blvd Ste a
Redwood City, CA 94063-1441
Phone
(650) 420-7761
Fax
(650) 839-7841
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
School Social Worker 1041S0200X
Clinical Social Worker 1041C0700X LCSW122142 CA Primary

Addresses

Primary practice location

647 Veterans Blvd Ste a
Redwood City, CA 94063-1441

Mailing address

PO Box 1011
Redwood City, CA 94064-1011
Phone (650) 420-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240826002067 CA Practitioner - Clinical Social Worker 8224577986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

647 Veterans Blvd
Suite a
Redwood City, CA 94063-1441
Phone (650) 906-4039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW122142CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine CHI Licensed Clinical Social Worker and Associates Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

647 Veterans Blvd
Ste A
Redwood City, CA 94063
Phone (650) 336-0054

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1316514748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1011",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940641011",
            "telephone_number": "650-420-7761",
            "fax_number": "650-839-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 VETERANS BLVD STE A",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631441",
            "telephone_number": "650-420-7761",
            "fax_number": "650-839-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW122142, PPSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW122142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.