Individual provider Active NPI

Katherine Marie Meyers, LICSW

  • Clinical Social Worker
  • Winona, MN
National Provider Identifier
1477800456
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24373 Issued in MN
Practice address
420 E Sarnia St Ste 2100
Winona, MN 55987-6414
Phone
(507) 454-4341
Fax
(507) 453-6267
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 128249-121 WI
Clinical Social Worker 1041C0700X 24373 MN Primary

Addresses

Primary practice location

420 E Sarnia St Ste 2100
Winona, MN 55987-6414

Mailing address

420 E Sarnia St Ste 2100
Winona, MN 55987-6414
Phone (507) 454-4341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180829000962 MN Practitioner - Clinical Social Worker 3678823408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24373MNMDClinical Social Worker
128249-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hiawatha Valley Mental Health Center Inc. CurrentSince Jan 7, 2022 Accepting new patients
Stellher Human Services, Inc. Past Accepting new patients
Peterson Medical Clinics, LLC PastSince Aug 9, 2018 Accepting new patients
Hiawatha Valley Mental Health Center PastSince Nov 15, 2020 Accepting new patients

Locations

221 S Kingston St
Caledonia, MN 55921
Phone (507) 725-2022

611 Broadway Ave
Ste 100
Wabasha, MN 55981
Phone (651) 565-2234

420 E Sarnia St
Ste 2100
Winona, MN 55987
Phone (507) 454-4341

Organizations & group practices 4

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1477800456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST STE 2100",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876414",
            "telephone_number": "507-454-4341",
            "fax_number": "507-453-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST STE 2100",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876414",
            "telephone_number": "507-454-4341",
            "fax_number": "507-453-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "128249-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.