Katelyn Favela

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61378659 Issued in WA

Practice address

9300 NE Oak View Dr Ste B
Vancouver, WA 98662-6157

Phone

(360) 567-2211

NPI assigned

Mar 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Catholic Community Services of Western Washington

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1558593350
  NPD (past)
• Real Life Community Behavioral Health PLLC

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1952063265
  NPD (past)

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1497117360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 NE OAK VIEW DR STE B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626157",
            "telephone_number": "360-567-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NE OAK VIEW DR STE B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626157",
            "telephone_number": "360-567-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVELA",
        "first_name": "KATELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61378659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gideon Lee Faulconer
• Katheryn Anne Faulconer, PMHNP-BC
• Christine Margoni Faulds, DNP, ARNP, ACNPC-AG
• Taylor Michelle Faulk, CDPT
• Antoinette Faustino
• Lee Mitchell Faver, PHD ABPP
• Kenneth Favour, M.D.
• Jameson Fay, DPT
• Shahram Fazilat, D.D.S.
• Aylar Fazlzadeh

• Clinical Social Worker in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.