Individual provider Active NPI

Katharine Malia Shumaker

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1871226654
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112614 Issued in CA
Practice address
470 E 3Rd St Ste C
Los Angeles, CA 90013-1630
Phone
(213) 620-5712
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 109724 CA
Social Worker 104100000X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 112614 CA Primary

Addresses

Primary practice location

470 E 3Rd St Ste C
Los Angeles, CA 90013-1630

Mailing address

470 E 3Rd St Ste C
Los Angeles, CA 90013-1630
Phone (213) 620-5712

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231007000439 CA Practitioner - Clinical Social Worker 0648625822 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112614CAMDClinical Social Worker
109724CAMDOther Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. Clinical CurrentSince Aug 14, 2023 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince May 14, 2024 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Aug 14, 2023 Accepting new patients

Locations

470 E 3rd St
Ste C
Los Angeles, CA 90013
Phone (213) 620-4712

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1871226654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 E 3RD ST STE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131630",
            "telephone_number": "213-620-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 E 3RD ST STE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131630",
            "telephone_number": "213-620-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "KATHARINE",
        "middle_name": "MALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "109724",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.