Individual provider Active NPI

Katharine E Schrock, LCSW

  • Clinical Social Worker
  • Goshen, IN
National Provider Identifier
1407855463
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004640A Issued in IN
Practice address
1930 W Lincoln Ave
Goshen, IN 46526-5907
Phone
(574) 534-2161
Fax
(574) 534-3887
NPI assigned
Jul 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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 34004640A IN Primary

Addresses

Primary practice location

1930 W Lincoln Ave
Goshen, IN 46526-5907

Mailing address

1930 W Lincoln Ave
Goshen, IN 46526-5907
Phone (574) 534-2161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070302000312 IN Practitioner - Clinical Social Worker 9133221559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

313 S 3Rd St
Goshen, IN 46526-3709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004640AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Katharine Schrock Counseling P.C. Clinical CurrentSince Dec 11, 2006 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

1930 W Lincoln Ave
Goshen, IN 46526
Phone (574) 534-2161

313 S 3rd St
Goshen, IN 46526
Phone (574) 535-0880

Organizations & group practices 2

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1407855463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907",
            "telephone_number": "574-534-2161",
            "fax_number": "574-534-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907",
            "telephone_number": "574-534-2161",
            "fax_number": "574-534-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROCK",
        "first_name": "KATHARINE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004640A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.