Individual provider Active NPI

Katherine Shaw York, LPC

  • Professional Counselor
  • Huntsville, AL
National Provider Identifier
1497514210
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC03550 Issued in AL
Practice address
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone
(256) 533-1970
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC03550 AL Primary

Addresses

Primary practice location

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364

Mailing address

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970

Other identifiers 1

IdentifierTypeStateIssuer
330000014MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240524002345 AL Practitioner - Mental Health Counselor 5698117422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstone, Inc. CurrentSince Apr 10, 2024 Accepting new patients

Locations

4040 Memorial Pkwy SW
Huntsville, AL 35802
Phone (256) 533-1970

Organizations & group practices 1

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": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1497514210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-533-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-533-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "KATHERINE",
        "middle_name": "SHAW",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC03550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.