Individual provider Active NPI

Laketra Chick

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1053772137
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S1502344 Issued in OH
Practice address
3325 Glenmore Ave
Cincinnati, OH 45211
Phone
(513) 231-6630
NPI assigned
Mar 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S1502344 OH Primary

Addresses

Primary practice location

3325 Glenmore Ave
Cincinnati, OH 45211

Mailing address

3325 Glenmore Ave
Cincinnati, OH 45211-6510
Phone (513) 231-6630

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

LicenseStateTypeSpecialty
S1502344OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1053772137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116510",
            "telephone_number": "513-231-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45211",
            "telephone_number": "513-231-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICK",
        "first_name": "LAKETRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1502344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.