Katelyn Ann Thain

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34011567A Issued in IN

Practice address

2629 Deerwood Dr
Fort Wayne, IN 46825-3919

Phone

(260) 530-3240

NPI assigned

Oct 12, 2022

Last updated

Dec 2, 2025By 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 2

Addresses

Other names 1

• Katelyn Ann Cooper Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IN

  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD (past)

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1700502705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 DEERWOOD DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253919",
            "telephone_number": "260-530-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 DEERWOOD DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468253919",
            "telephone_number": "260-530-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAIN",
        "first_name": "KATELYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33010658A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34011567A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "COOPER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Ann Terwilleger, RN
• Grettel T Tesado, M.D.
• Matthew John Tescula, DO
• Susan L Teubner, COTA
• Hermela Tezera, M.D.
• Anayet Uddin Thakur, M.D.
• Allyson Thammachack
• Felicity Thammavongsa
• Zin M Than, MD
• Anup Thapa

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.