Active NPI
Katherine M. Pendleton, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1710126644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 41045
- Practice address
- 12916 Schleicher TRL
Austin, TX 78732-2286 - Phone
- (512) 517-7975
- Fax
- (512) 323-9490
- NPI assigned
- Feb 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 41045 | TX | Primary |
Addresses
Primary practice location
12916 Schleicher TRL
Austin, TX 78732-2286
Mailing address
12916 Schleicher TRL
Austin, TX 78732-2286
Phone (512) 517-7975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220205302 | Medicaid | TX |
Other names 1
- Katherine Shanahan
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41045 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1710126644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12916 SCHLEICHER TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787322286",
"telephone_number": "512-517-7975",
"fax_number": "512-323-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12916 SCHLEICHER TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787322286",
"telephone_number": "512-517-7975",
"fax_number": "512-323-9490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDLETON",
"first_name": "KATHERINE",
"middle_name": "M.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-17",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "41045",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220205302",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "SHANAHAN",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.