Individual provider Active NPI

Katelyn Lee, LCSW

  • Clinical Social Worker
  • La Follette, TN
National Provider Identifier
1790244416
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7941 Issued in TN
Practice address
130 Independence Lane
Lafollette, TN 37766-3073
Phone
(423) 562-1705
Fax
(423) 566-3718
NPI assigned
Mar 13, 2019
Last updated
Jul 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7941 TN Primary

Addresses

Primary practice location

130 Independence Lane
Lafollette, TN 37766-3073

Mailing address

130 Independence Lane
P O Box 493
Lafollette, TN 37766-3073
Phone (423) 562-1705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220726000948 TN Practitioner - Clinical Social Worker 6406237288 Reassigns benefits to 1 organization
Practice locations: Jacksboro, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7941TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of East Tennessee, Inc CurrentSince Jul 18, 2022 Accepting new patients
Impact Healthcare, PLLC Past Accepting new patients

Locations

130 Independence Ln
La Follette, TN 37766
Phone (423) 562-1705

130 Independence Ln
Ste 1
La Follette, TN 37766
Phone (423) 562-1705

Interoperability endpoints

  • Direct secure messaging: katelyn.leelcsw.p1@direct.chetn.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1790244416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 INDEPENDENCE LANE",
            "address_2": "P O BOX 493",
            "city": "LAFOLLETTE",
            "state": "TN",
            "postal_code": "377663073",
            "telephone_number": "423-562-1705",
            "fax_number": "423-566-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 INDEPENDENCE LANE",
            "city": "LAFOLLETTE",
            "state": "TN",
            "postal_code": "377663073",
            "telephone_number": "423-562-1705",
            "fax_number": "423-566-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KATELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Follette, TN

Sources for this page

Verify at the official NPI Registry.