Individual provider Active NPI

Sivi Ceruti Kizinga, LCSWA

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1093557829
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
200 Davis Park Rd
Gastonia, NC 28052-0116
Phone
(704) 866-6618
Fax
(704) 866-6320
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 Primary

Addresses

Primary practice location

200 Davis Park Rd
Gastonia, NC 28052-0116

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

Other practice location 1

9541 Julian Clark Ave Ste 208
Huntersville, NC 28078-3486
Phone (704) 796-9037

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc PastSince Dec 21, 2025 Accepting new patients
Gaston Family Health Services, Inc. PastSince Dec 21, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: skizinga733984@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1093557829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DAVIS PARK RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280520116",
            "telephone_number": "704-866-6618",
            "fax_number": "704-866-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9541 Julian Clark Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280783486",
            "country_code": "US",
            "telephone_number": "704-796-9037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIZINGA",
        "first_name": "SIVI",
        "middle_name": "CERUTI",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.