Katelyn Marie Anderson, MSW, CSW-PIP, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5213 Issued in SD

Practice address

3515 Broadway Ave
Yankton, SD 57078-4917

Phone

(605) 668-3100

NPI assigned

Jun 26, 2021

Last updated

Oct 27, 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 NE

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Osmond General Hospital Inc

  dba Randolph Family Practice Clinic

  • Family Medicine Physician
  • Randolph, NE
  • NPI 1700979614
  Medicare reassignment NPD
• Osmond General Hospital Inc

  dba Wausa Medical Clinic

  • Family Medicine Physician
  • Wausa, NE
  • NPI 1700979622
  NPD
• Osmond General Hospital Inc

  dba Osmond Family Practice

  • Rural Health Clinic/Center
  • Osmond, NE
  • NPI 1710307673
  NPD

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1609446319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7600",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570787600",
            "telephone_number": "605-668-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784917",
            "telephone_number": "605-668-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "MSW, CSW-PIP, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2842",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "5213",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• All Smiles Dental Care
• Tami Ambroson, LPC, NCC
• American Pain Relief Institute Prof LLC
• Danene Anderson
• Jarrod Anderson
• Paul S Anderson, OD
• William J. Andrews, MD
• Victoria J Antle-Vlach, MD
• Cassandra Arens, PA
• Sarah Arens

• Clinical Social Worker in Yankton, SD
• Providers in Yankton, SD by specialty
• Clinical Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.