Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katherine Maynor, MSW, LCSW

Individual provider Clinical Social Worker · NPI 1790346872

Katherine Maynor, MSW, LCSW is a Clinical Social Worker in Charlotte, North Carolina. Qualified in 2019, 7 years ago. Practices with Southpark Psychotherapy PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2019
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5821 Fairview Rd Ste 200
Charlotte, NC 28209-3649
Phone: (980) 580-0639
Fax: (980) 580-0507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C017301 (NC)

Record details

NPI number1790346872
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LCSW
Sole proprietorNo
NPI enumeratedJune 27, 2019
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Southpark Psychotherapy Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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