Individual provider Active NPI

Katherine Elizabeth Fouty, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1952834178
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011319 Issued in NC
Practice address
806 Hay St
Fayetteville, NC 28305-5312
Phone
(910) 860-7008
NPI assigned
Apr 5, 2017
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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 P011319 NC Primary

Addresses

Primary practice location

806 Hay St
Fayetteville, NC 28305-5312

Mailing address

806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008

Other names 1

  • Katherine Elizabeth Hagan Former 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
I20190918000339 NC Practitioner - Clinical Social Worker 3870823891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P011319NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Haymount Institute for Psychological Services, PLLC Professional Current Accepting new patients
Haymount Institute for Psychological Services, PLLC Clinical CurrentSince Aug 1, 2019 Accepting new patients
Haymount Institute for Psychological Services, PLLC Professional CurrentSince Aug 1, 2019 Accepting new patients
Cape Fear Behavioral Health Center LLC PastSince Apr 20, 2026 Accepting new patients

Locations

806 Hay St
Fayetteville, NC 28305
Phone 9108607008117

3507 Hill St
Hope Mills, NC 28348
Phone (910) 339-0901

131 W Edinborough Ave
Raeford, NC 28376
Phone (910) 848-1222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1952834178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTY",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HAGAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.