KATELYN BROOKE MEDINA LCSW
NPI 1063011153
Social Worker - Clinical in Charlotte, NC

Q: What is Katelyn Medina's NPI number?

The NPI number for Katelyn Medina is 1063011153. It was assigned to this individual provider in the NPPES registry on October 20, 2020. The provider is also known as Katelyn Brooke Locklear.

Q: What is Katelyn Medina's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Katelyn Medina was last updated on May 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2020

5200 PARK RD STE 218B, CHARLOTTE, NC 28209(866) 700-1606 Get Directions Write a Review

NPPES record last updated: May 17, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 17, 2023, Nov 10, 2020, Oct 20, 2020 (3 updates tracked since 2020).

On this page

About Katelyn Brooke Medina Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATELYN BROOKE MEDINA LCSW (NPI 1063011153) is an individual clinical provider in Charlotte, North Carolina, licensed in North Carolina (C015751) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1063011153

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKATELYN BROOKE MEDINACredential: LCSW

Location Address5200 PARK RD STE 218BCharlotte, NC 28209-3650

Mailing AddressPo Box 8879Asheville, NC 28814-8879 · (866) 700-1606

Phone(866) 700-1606

Sole ProprietorYes

Enumeration DateOctober 20, 2020

Last NPPES UpdateMay 17, 20233 updates tracked since enumeration

NPPES CertifiedMay 17, 2023

✔ NPI 1063011153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · C015751

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

5200 PARK RD STE 218B, Charlotte, NC 28209

Open in Google Maps ↗

Other Names 1

Former Name (1)Katelyn Brooke Locklear

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSEY YVETTE DONATIEN LCMHC

Counselor (Professional)