Individual provider Active NPI

Katherine Wilson, LCSW

  • Clinical Social Worker
  • Anderson, IN
National Provider Identifier
1922650308
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008543A Issued in IN
Practice address
1933 Chase St
Anderson, IN 46016-4238
Phone
(317) 574-1254
Fax
(317) 674-0060
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008543A IN Primary

Addresses

Primary practice location

1933 Chase St
Anderson, IN 46016-4238

Mailing address

9615 E 148TH St Ste 1
Noblesville, IN 46060-4371
Phone (317) 574-1254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190731001260 IN Practitioner - Clinical Social Worker 2365778172 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34008543AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Indiana Inc. Clinical CurrentSince May 2, 2020 Accepting new patients

Locations

2020 Brown St
Anderson, IN 46016
Phone (317) 649-8161

2009 Brown St
Anderson, IN 46016
Phone (765) 393-3891

4038 Ridgeview Dr
Anderson, IN 46013

1933 Chase St
Anderson, IN 46016
Phone (765) 622-7466

697 Pro Med Ln
Carmel, IN 46032
Phone (317) 574-0055

10731 N State Road 13
Elwood, IN 46036
Phone (765) 552-5009

2506 Willowbrook Pkwy
Ste 300
Indianapolis, IN 46205
Phone (317) 587-0567

201 Shelby St
Indianapolis, IN 46202
Phone (317) 637-9816

1600 W Main St
Lebanon, IN 46052
Phone (765) 335-7702

9615 E 148th St
Ste 1
Noblesville, IN 46060
Phone (317) 587-0500

17840 Cumberland Rd
Noblesville, IN 46060
Phone (317) 773-6864

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1922650308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 E 148TH ST STE 1",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604371",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 CHASE ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164238",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008543A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.