Individual provider Active NPI

Kristine Monique Hitchens, PHD, LCSW-C, LCADC

  • Clinical Social Worker
  • Bel Air, MD
National Provider Identifier
1013458678
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11558 Issued in MD
Practice address
539 Rock Spring Rd
Bel Air, MD 21014-2940
Phone
(443) 466-8024
NPI assigned
Mar 16, 2017
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA219 MD
Clinical Social Worker 1041C0700X 11558 MD Primary

Addresses

Primary practice location

539 Rock Spring Rd
Bel Air, MD 21014-2940

Mailing address

296 N Saint Augustine Rd
Chesapeake City, MD 21915-1311
Phone (443) 466-8024

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230307000046 MD Practitioner - Clinical Social Worker 2961875380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 E Cecil Ave
Suite D
North East, MD 21901-4057
Phone (443) 945-9663

296 N Saint Augustine Rd
Chesapeake City, MD 21915-1311

304 N Saint Augustine Rd
Chesapeake City, MD 21915-1310
Phone (443) 945-9663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCA219MDMDAddiction (Substance Use Disorder) Counselor
11558MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Change Would DO You Good, LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

102 E Cecil Ave
Ste D
North East, MD 21901
Phone (443) 877-6959

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1013458678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 N SAINT AUGUSTINE RD",
            "city": "CHESAPEAKE CITY",
            "state": "MD",
            "postal_code": "219151311",
            "telephone_number": "443-466-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 ROCK SPRING RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210142940",
            "telephone_number": "443-466-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHENS",
        "first_name": "KRISTINE",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW-C, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA219",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.