Active NPI
Katherine Maria Clayborne, MS, ED.S
- School Psychologist
- Fountain Hills, AZ
National Provider Identifier
1790417806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2572183
- Practice address
- 17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663 - Phone
- (314) 610-9246
- NPI assigned
- Jun 28, 2022
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2572183 | IL | Primary |
Addresses
Primary practice location
17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663
Mailing address
17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663
Phone (314) 610-9246
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2572183 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1790417806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17100 E SHEA BLVD STE 600",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852686663",
"telephone_number": "314-610-9246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17100 E SHEA BLVD STE 600",
"city": "FOUNTAIN HILLS",
"state": "AZ",
"postal_code": "852686663",
"telephone_number": "314-610-9246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYBORNE",
"first_name": "KATHERINE",
"middle_name": "MARIA",
"credential": "MS, ED.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-28",
"last_updated": "2022-06-28",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "2572183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Hills, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.