Kathey Michelle Wilborn, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS15195 Issued in CA

Practice address

1225 W 190TH St Ste 205
Gardena, CA 90248-4336

Phone

(888) 227-0649

Fax

(888) 434-7923

NPI assigned

Sep 20, 2007

Sex

Female

Sole proprietor

Yes

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 CA

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1841486131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5201",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902495201",
            "telephone_number": "310-844-3431",
            "fax_number": "310-891-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 205",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484336",
            "telephone_number": "888-227-0649",
            "fax_number": "888-434-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBORN",
        "first_name": "KATHEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tisla White
• Sondra Whitehead
• Erma Jean Whitfield
• Courtney Whittle, MD MSW
• Brianna Kayla Wicker
• Katelyn Shea Wildes
• Bryana Wiles
• Briana Wiley
• William Essilfie, M.D., Inc.
• Aarin Ables Williams, MS, LCGC

• Clinical Social Worker in Gardena, CA
• Providers in Gardena, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.