Kaitlan Phillips, LMSW
Individual provider Active NPI Social Worker · Rising Sun, MD
NPI 1003380643 · NPPES record last updated Jan 16, 2019
Key facts
- NPI
- 1003380643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 21503 (MD)
- Practice address
- 19 Ridge Rd
Rising Sun, MD 21911-1545 - Phone
- (302) 824-9636
- NPI assigned
- Jan 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Safe Harbor Behavioral Care LLC
Practice addresses (Care Compare)
260 Gateway Dr
Suite 11 12C
Bel Air, MD 21014-4268
Phone (410) 893-4600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201230001491 | MD | Practitioner - Clinical Social Worker | 6800209339 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safe Harbor Community Services | Current |
Accepting new patients | |
| Safe Harbor Behavioral Care, LLC | Social Worker | Current |
Accepting new patients |
Locations
1208 E Churchville Rd
Ste 300
Bel Air, MD 21014
Phone (410) 838-9500
260 Gateway Dr
Ste 1112C
Bel Air, MD 21014
2227 Old Emmorton Rd
Ste 115
Bel Air, MD 21015
Phone (410) 589-0999
2227 Old Emmorton Rd
Ste 119
Bel Air, MD 21015
Phone (410) 561-9497
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 21503 | MD | Yes |
Addresses
Primary practice location
19 Ridge Rd
Rising Sun, MD 21911-1545
Mailing address
19 Ridge Rd
Rising Sun, MD 21911-1545
Other providers in Rising Sun, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.