Individual provider Active NPI

Kaitlin Merritt, L.C.S.W

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1063879260
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW130967 Issued in CA
Practice address
6043 Hollywood Blvd
Los Angeles, CA 90028-5411
Phone
(323) 653-1990
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW019170 PA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW130967 CA Primary

Addresses

Primary practice location

6043 Hollywood Blvd
Los Angeles, CA 90028-5411

Mailing address

6043 Hollywood Blvd
Los Angeles, CA 90028-5411
Phone (323) 653-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161110000692 PA Practitioner - Clinical Social Worker 4486933652 Reassigns benefits to 1 organization
I20250731003248 CA Practitioner - Clinical Social Worker 4486933652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW130967CAMDClinical Social Worker
CW019170PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia Multi-Specialty Current Accepting new patients
The Los Angeles Free Clinic CurrentSince May 19, 2025 Accepting new patients
City of Philadelphia CurrentSince Oct 3, 2016 Accepting new patients
City of Philadelphia CurrentSince Oct 3, 2016 Accepting new patients
The Los Angeles Free Clinic Multi-Specialty CurrentSince May 19, 2025 Accepting new patients

Locations

137 N Virgil Ave
Los Angeles, CA 90004
Phone (323) 336-8420

5205 Melrose Ave
Los Angeles, CA 90038
Phone (323) 337-1878

6043 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 653-1990

8405 Beverly Blvd
West Hollywood, CA 90048
Phone (323) 653-1990

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

321 W Girard Ave
#6
Philadelphia, PA 19123
Phone (215) 685-3803

1101 Market St
Fl 10
Philadelphia, PA 19107

Organizations & group practices 5

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": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1063879260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285411",
            "telephone_number": "323-653-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285411",
            "telephone_number": "323-653-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "KAITLIN",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019170",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW130967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.