Individual provider Active NPI

Katherine Anne Meyer, L.C.S.W.

  • Clinical Social Worker
  • Flagstaff, AZ
National Provider Identifier
1336332253
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-12589 Issued in AZ
Practice address
405 N Beaver St Ste 9
Flagstaff, AZ 86001-4500
Phone
(928) 286-7229
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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 LCSW-12589 AZ Primary

Addresses

Primary practice location

405 N Beaver St Ste 9
Flagstaff, AZ 86001-4500

Mailing address

PO Box 22132
Flagstaff, AZ 86002-2132
Phone (928) 286-7229

Other identifiers 1

IdentifierTypeStateIssuer
P200628OtherAZBCBSAZ

Other names 1

  • Katherine Anne Gendron Former name

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

LicenseStateTypeSpecialty
LCSW-12589AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Health and Wellness Clinical CurrentSince Jan 15, 2023 Accepting new patients
Balance Mental Health and Wellness LLC. CurrentSince Jan 15, 2023 Accepting new patients
Arizona Behavioral Health Associates, P.C. PastSince Oct 29, 2024 Accepting new patients

Locations

405 N Beaver St
Ste 9
Flagstaff, AZ 86001
Phone (928) 286-7229

Organizations & group practices 3

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1336332253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22132",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860022132",
            "telephone_number": "928-286-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N BEAVER ST STE 9",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014500",
            "telephone_number": "928-286-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "P200628",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "GENDRON",
            "middle_name": "ANNE",
            "credential": "L.M.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.

Verify at the official NPI Registry.