Individual provider Active NPI

Katrina Grace Kotcher, LMSW, CAADC

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1821205857
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090197 Issued in MI
Practice address
14120 Hix St
Livonia, MI 48154-4903
Phone
(734) 233-4131
NPI assigned
May 17, 2007
Last updated
Mar 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C-01547 MI
Clinical Social Worker 1041C0700X 6801090197 MI Primary

Addresses

Primary practice location

14120 Hix St
Livonia, MI 48154-4903

Mailing address

14120 Hix St
Livonia, MI 48154-4903
Phone (734) 233-4131

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

State licenses

LicenseStateTypeSpecialty
C-01547MIMDAddiction (Substance Use Disorder) Counselor
6801090197MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1821205857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14120 HIX ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544903",
            "telephone_number": "734-233-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14120 HIX ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544903",
            "telephone_number": "734-233-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTCHER",
        "first_name": "KATRINA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-01547",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.