Individual provider Active NPI

Kimberly Witt, LCSW

  • Clinical Social Worker
  • Lancaster, PA
National Provider Identifier
1043754948
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW021211 Issued in PA
Practice address
1018 N Christian St Ste 203
Lancaster, PA 17602-1900
Phone
(717) 820-7748
Fax
(570) 253-5990
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW133938 PA
Clinical Social Worker 1041C0700X CW021211 PA Primary

Addresses

Primary practice location

1018 N Christian St Ste 203
Lancaster, PA 17602-1900

Mailing address

1018 N Christian St Ste 203
Lancaster, PA 17602-1900
Phone (717) 820-7748

Other identifiers 1

IdentifierTypeStateIssuer
1036677420001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW133938PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Magis Mental Health LLC Clinical CurrentSince Mar 24, 2024 Accepting new patients

Locations

1018 N Christian St
Ste 203
Lancaster, PA 17602
Phone (717) 820-7748

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1043754948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N CHRISTIAN ST STE 203",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176021900",
            "telephone_number": "717-820-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N CHRISTIAN ST STE 203",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176021900",
            "telephone_number": "717-820-7748",
            "fax_number": "570-253-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133938",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036677420001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.