Active NPI
Katerina Smallcomb, ASW
- Mental Health Counselor
- Ukiah, CA
National Provider Identifier
1669955506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 169 Mason St
Ukiah, CA 95482-4482 - Phone
- (707) 463-3300
- Fax
- (707) 463-3318
- NPI assigned
- Sep 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CA | Primary | |
| Social Worker | 104100000X |
Addresses
Primary practice location
169 Mason St
Ukiah, CA 95482-4482
Mailing address
3900 Deerwood Dr
Ukiah, CA 95482-3686
Phone (970) 590-6652
Other practice location 1
835 Maya Way
Ukiah, CA 95482-5108
Phone (707) 462-2538
Other practice location 2
776 S State St Ste 107
Ukiah, CA 95482-5858
Phone (707) 463-4915
Other practice location 3
290 E Gobbi St
Ukiah, CA 95482-5559
Phone (707) 463-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1669955506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 DEERWOOD DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954823686",
"telephone_number": "970-590-6652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 MASON ST",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824482",
"telephone_number": "707-463-3300",
"fax_number": "707-463-3318"
}
],
"practiceLocations": [
{
"address_1": "835 Maya Way",
"address_purpose": "LOCATION",
"city": "Ukiah",
"state": "CA",
"postal_code": "954825108",
"country_code": "US",
"telephone_number": "707-462-2538",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "776 S State St Ste 107",
"address_purpose": "LOCATION",
"city": "Ukiah",
"state": "CA",
"postal_code": "954825858",
"country_code": "US",
"telephone_number": "707-463-4915",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "290 E Gobbi St",
"address_purpose": "LOCATION",
"city": "Ukiah",
"state": "CA",
"postal_code": "954825559",
"country_code": "US",
"telephone_number": "707-463-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMALLCOMB",
"first_name": "KATERINA",
"credential": "ASW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.