KATHERINE PROVEAUX LICSW
NPI 1609634617
Social Worker - Clinical in Duluth, MN

Q: What is Katherine Proveaux's NPI number?

The NPI number for Katherine Proveaux is 1609634617. It was assigned to this individual provider in the NPPES registry on March 13, 2024.

Q: What is Katherine Proveaux's specialty?

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

Q: Is Katherine Proveaux enrolled in Medicare?

No. Katherine Proveaux has opted out of Medicare through July 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since March 13, 2024Opted out of Medicare · through Jul 9, 2028

324 W SUPERIOR ST STE 620, DULUTH, MN 55802(218) 606-1797 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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About Katherine Proveaux Licsw NPPES

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

KATHERINE PROVEAUX LICSW (NPI 1609634617) is an individual clinical provider in Duluth, Minnesota, licensed in Minnesota (23661) and active in the NPI registry since March 2024. She has opted out of Medicare through July 9, 2028.

NPPES Registry Identity

NPI1609634617

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKATHERINE PROVEAUXCredential: LICSW

Location Address324 W SUPERIOR ST STE 620Duluth, MN 55802-1723

Mailing Address324 W Superior St Ste 620Duluth, MN 55802-1723 · (218) 606-1797

Phone(218) 606-1797

Sole ProprietorNo

Enumeration DateMarch 13, 2024

Last NPPES UpdateMarch 18, 2024

NPPES CertifiedMarch 18, 2024

✔ NPI 1609634617 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 MN · 23661

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.

324 W SUPERIOR ST STE 620, Duluth, MN 55802

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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

Katherine Proveaux Licsw 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 July 9, 2024 through July 9, 2028.

Opt-Out Effective DateJuly 9, 2024

Opt-Out In Effect ThroughJuly 9, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 13

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

TREVOR SWOVERLAND MSW, LICSW

Social Worker (Clinical)