Katie Willis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2021034810 Issued in MO

Practice address

901 NE Independence Ave
Lees Summit, MO 64086-5544

Phone

(816) 246-8000

NPI assigned

Jul 20, 2020

Last updated

Sep 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RediscoverGroup PAC ID 3375453517, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rediscover

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lee's Summit, MO
  • NPI 1841235298
  Medicare reassignment Care Compare group NPD
• Rediscover

  • Methadone Clinic
  • Kansas City, MO
  • NPI 1659749414
  NPD
• Rediscover

  • Adult Mental Health Clinic/Center
  • Lee's Summit, MO
  • NPI 1063552636
  NPD (past)

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1336757053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 NE INDEPENDENCE AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865544",
            "telephone_number": "816-246-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NE INDEPENDENCE AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865544",
            "telephone_number": "816-246-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KATIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2013031634",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "8796",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021034810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael E Williams, M.D.
• Sharon L Williams
• Tara C. Williams, BCBA
• Zachary Thomas Williams, D.D.S., M.C.L.D.
• Emily Ann Williamson, LMSW
• Wilshire Operator LLC (Wilshire at Lakewood Rehab Center)
• Barry Scott Wilson, D.C.
• Crosby Wilson
• David Wilson, RPH
• David Demetrius Wilson, DC, MS

• Clinical Social Worker in Lee's Summit, MO
• Providers in Lee's Summit, 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 Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.