Katelyn King, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019364 Issued in PA

Practice address

622 H St
Eureka, CA 95501-1026

Phone

(707) 443-4666

Fax

(707) 441-4833

NPI assigned

Aug 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Open Door Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1932576006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHELFIELD RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190381401",
            "telephone_number": "267-469-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 H ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011026",
            "telephone_number": "707-443-4666",
            "fax_number": "707-441-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 E Mermaid Ln",
            "address_purpose": "LOCATION",
            "city": "Wyndmoor",
            "state": "PA",
            "postal_code": "190387634",
            "country_code": "US",
            "telephone_number": "267-469-0076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Chelfield Rd",
            "address_purpose": "LOCATION",
            "city": "Glenside",
            "state": "PA",
            "postal_code": "190381401",
            "country_code": "US",
            "telephone_number": "215-831-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KATELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW109044",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Robert Kime III, DDS
• King Chiropractic, a Shapiro Professional Corporation
• Chantal Nicole King
• Geerdina Maria Arnolda King
• Heather King, ASW
• Leah King, RD
• Paul Richard King, OD
• Sarah Kingstrom, PA-C
• Ashley Dawn Kinman
• Lillian Kinsey

• Clinical Social Worker in Eureka, CA
• Providers in Eureka, 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 Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.