Kellie Jean Dawson, L.I.S.W-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I. 0009062 SUPV Issued in OH

Practice address

163 N Sandusky St Ste 104
Delaware, OH 43015-1778

Phone

(614) 946-7571

Fax

(740) 879-2826

NPI assigned

Aug 25, 2006

Last updated

Aug 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 OH

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Delaware Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Delaware, OH
  • NPI 1760741110
  Medicare reassignment NPD Authorized official
• Northwoods Clinic, LLC

  • Child & Adolescent Psychiatry Physician
  • Columbus, OH
  • NPI 1841698669
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1053429605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N SANDUSKY ST STE 104",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151778",
            "telephone_number": "614-946-7571",
            "fax_number": "740-879-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 N SANDUSKY ST STE 104",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151778",
            "telephone_number": "614-946-7571",
            "fax_number": "740-879-2826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430151699",
            "country_code": "US",
            "telephone_number": "740-363-8171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "KELLIE",
        "middle_name": "JEAN",
        "credential": "L.I.S.W-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.  0009062   SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynne Datta, N.P.
• Elizabeth Ann Daugherty, LPN
• Andrew Scott Davis, RN
• Bryan Davis, PC
• Shelley Davis, LSW
• Meredith Day
• Dca of Delaware County LLC (U S Renal Care Delaware County Dialysis)
• Andre Mikael De Leon, MD
• Matthias Debecker, DPT
• Delaware Care, LLC (Arbors at Delaware)

• Clinical Social Worker in Delaware, OH
• Providers in Delaware, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.