Individual provider Active NPI

Katherine Davey Berry, LCSW

  • Clinical Social Worker
  • Roseville, CA
National Provider Identifier
1922689959
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
130415 Issued in CA
Practice address
101 Cirby Hills Dr
Roseville, CA 95678-4360
Phone
(916) 787-8846
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 130415 CA Primary

Addresses

Primary practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Mailing address

101 Cirby Hills Dr
Roseville, CA 95678-4360

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
I20260116003666 CA Practitioner - Clinical Social Worker 1254818594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

500 Westover Dr
Sanford, NC 27330-8941

PO Box
Suite 340563
Sacramento, CA 95834

PO Box
Suite 340563
Sacramento, CA 95834-0563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130415CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince Jan 8, 2026 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 1

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1922689959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIRBY HILLS DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784360",
            "telephone_number": "916-787-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KATHERINE",
        "middle_name": "DAVEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "130415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.