Individual provider Active NPI

Karen Zittleman, LCSW

  • Clinical Social Worker
  • Ocean Springs, MS
National Provider Identifier
1063779734
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C3768 Issued in MS
Practice address
900 Magnolia Bayou Blvd
Ocean Springs, MS 39564-8391
Phone
(228) 326-7575
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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 C3768 MS Primary

Addresses

Primary practice location

900 Magnolia Bayou Blvd
Ocean Springs, MS 39564-8391

Mailing address

2112 Bienville Blvd Ste K
Ocean Springs, MS 39564-3067
Phone (228) 819-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120530000375 MS Practitioner - Clinical Social Worker 2062675143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4836 Main St
Moss Point, MS 39563-2700
Phone (228) 278-5109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C3768MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Social Work LLC CurrentSince Aug 15, 2023 Accepting new patients
Nursing Home Psychological Services, LLC Past Accepting new patients

Locations

4836 Main St
Moss Point, MS 39563
Phone (228) 278-5109

Organizations & group practices 2

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1063779734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 BIENVILLE BLVD STE K",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643067",
            "telephone_number": "228-819-2171",
            "fax_number": "228-205-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAGNOLIA BAYOU BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648391",
            "telephone_number": "228-326-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITTLEMAN",
        "first_name": "KAREN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C3768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.