Individual provider Active NPI

Katherine McIntosh, LCSW

  • Clinical Social Worker
  • Mooresville, NC
National Provider Identifier
1902207384
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010292 Issued in NC
Practice address
206 N Main St
Mooresville, NC 28115-2528
Phone
(704) 879-5808
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P008858 NC
Clinical Social Worker 1041C0700X C010292 NC Primary

Addresses

Primary practice location

206 N Main St
Mooresville, NC 28115-2528

Mailing address

206 N Main St
Mooresville, NC 28115-2528
Phone (704) 879-5808

Other names 1

  • Katherine Hutto Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161021001813 NC Practitioner - Clinical Social Worker 8729366927 Reassigns benefits to 1 organization
Practice locations: Mooresville, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 N Main St
Mooresville, NC 28115-2528
Phone (704) 879-5808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P008858NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Geode Health of North Carolina, PLLC CurrentSince Jul 8, 2024 Accepting new patients
Mood and Food Connections, PLLC Clinical CurrentSince Jan 1, 2023 Accepting new patients

Locations

500 S Main St
Ste 113A
Mooresville, NC 28115
Phone (704) 879-5808

136 Fairview Rd
Ste 125
Mooresville, NC 28117
Phone (704) 317-5929

206 N Main St
Mooresville, NC 28115
Phone (704) 879-5808

Organizations & group practices 2

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1902207384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152528",
            "telephone_number": "704-879-5808",
            "fax_number": "704-519-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152528",
            "telephone_number": "704-879-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008858",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HUTTO",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.