Katherine Maynor, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C017301 Issued in NC

Practice address

5821 Fairview Rd Ste 200
Charlotte, NC 28209-3649

Phone

(980) 580-0639

Fax

(980) 580-0507

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southpark Psychotherapy PLLCGroup PAC ID 3476089152, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Southpark Psychotherapy PLLC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1679285043
  Medicare reassignment Care Compare group NPD
• Carolina Parenting Solutions, PLLC

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1265611271
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1790346872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093649",
            "telephone_number": "980-580-0639",
            "fax_number": "980-580-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNOR",
        "first_name": "KATHERINE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander D Maynard
• Brittany Maynard
• Debra Hill Maynard, MS, RDN
• John Ryan Maynard, P.A.
• Shabria Latae Mayne, MS, LPC, LCASA, NCC
• Michael Mayo
• Patricia Cox Mayo, M.S., CCC-SLP
• Nyimon Mayom
• Mays Counseling Services
• Agnes D. Mays, LCAS

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.