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MRS. KATHRYN RUSSELL BAUCOM LCSW
NPI 1336366566
Social Worker - Clinical in Cary, NC

Active since April 19, 2007Opted out of Medicare · through Dec 12, 2027
203 GENTLEWOODS DR, CARY, NC 27518(502) 200-2550 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 1, 2024, Sep 3, 2020, Dec 21, 2015 (3 updates tracked since 2015).

About Mrs. Kathryn Russell Baucom Lcsw NPPES

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

MRS. KATHRYN RUSSELL BAUCOM LCSW (NPI 1336366566) is an individual clinical provider in Cary, North Carolina, licensed in Kentucky (1012) and active in the NPI registry since April 2007. She has opted out of Medicare through December 12, 2027.

NPPES Registry Identity

NPI1336366566
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. KATHRYN RUSSELL BAUCOMCredential: LCSW
Location Address203 GENTLEWOODS DRCary, NC 27518-8662
Mailing Address203 Gentlewoods DrCary, NC 27518-8662 · (502) 200-2550
Phone(502) 200-2550
Sole ProprietorNo
Enumeration DateApril 19, 2007
Last NPPES UpdateOctober 1, 20243 updates tracked since enumeration
NPPES CertifiedOctober 1, 2024
✔ NPI 1336366566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in KY · 1012✔ Licensed in NC · C014265
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.
203 GENTLEWOODS DR, Cary, NC 27518
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kathryn Russell Baucom Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 12, 2023 through December 12, 2027.

Opt-Out Effective DateDecember 12, 2023
Opt-Out In Effect ThroughDecember 12, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathryn Baucom's NPI number?

The NPI number for Kathryn Baucom is 1336366566. It was assigned to this individual provider in the NPPES registry on April 19, 2007.

Where is Kathryn Baucom located?

Kathryn Baucom practices at 203 Gentlewoods Dr, Cary, NC 27518. The listed phone number is (502) 200-2550.

What is Kathryn Baucom's specialty?

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

Is Kathryn Baucom enrolled in Medicare?

No. Kathryn Baucom has opted out of Medicare through December 12, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kathryn Baucom was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.