Active NPI
Kimberly Dawn Sellers, LISW-S
- Social Worker
- Lebanon, OH
National Provider Identifier
1053721522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I.0800299-SUPV
- Practice address
- 212 N Broadway St
Suite 7
Lebanon, OH 45036-2736 - Phone
- (513) 228-6023
- NPI assigned
- May 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I.0800299-SUPV | OH | Primary |
Addresses
Primary practice location
212 N Broadway St
Suite 7
Lebanon, OH 45036-2736
Mailing address
306 Countryside Dr
Lebanon, OH 45036-7865
Phone (513) 236-4954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.0800299-SUPV | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1053721522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 COUNTRYSIDE DR",
"city": "LEBANON",
"state": "OH",
"postal_code": "450367865",
"telephone_number": "513-236-4954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 N BROADWAY ST",
"address_2": "SUITE 7",
"city": "LEBANON",
"state": "OH",
"postal_code": "450362736",
"telephone_number": "513-228-6023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "KIMBERLY",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "LISW-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-05",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I.0800299-SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.