Kaitlan Phillips, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

21503 Issued in MD

Practice address

19 Ridge Rd
Rising Sun, MD 21911-1545

Phone

(302) 824-9636

NPI assigned

Jan 16, 2019

Last updated

Jan 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879
  Medicare reassignment Care Compare group NPD
• Safe Harbor Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bel Air, MD
  • NPI 1184209447
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1003380643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 RIDGE RD",
            "city": "RISING SUN",
            "state": "MD",
            "postal_code": "219111545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 RIDGE RD",
            "city": "RISING SUN",
            "state": "MD",
            "postal_code": "219111545",
            "telephone_number": "302-824-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KAITLAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelmdllc
• New Day Support Services
• Michelle Kristen Nimmo, MS, CCC-SLP
• Osborne Mental Wellness
• Jennifer Perry, LGPC
• Physiotherapy Associates - Union Rehab LLC (Physiotherapy Associates)
• Jonathan Michael Pilgrim, LAC
• Antonio Eacdine Pomponi, MPT CERT MDT
• Razullah Khwaja, M.D.
• Rising Wellness Counseling LLC

• Social Worker in Rising Sun, MD
• Providers in Rising Sun, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.