Individual provider Active NPI

Kathleen Klemer Gumienny, LCSW C

  • Clinical Social Worker
  • Kingston, PA
National Provider Identifier
1093785339
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CWO15775 Issued in PA
Practice address
480 Pierce St
#305
Kingston, PA 18704-5512
Phone
(410) 991-2077
Fax
(570) 696-1526
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 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 CWO15775 PA Primary
Social Worker 104100000X 07971 MD

Addresses

Primary practice location

480 Pierce St
#305
Kingston, PA 18704-5512

Mailing address

2031 Rudy Serra Dr Unit 3a
Sykesville, MD 21784-6552
Phone (410) 991-2077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20121005000389 PA Practitioner - Clinical Social Worker 8123277159 Practice locations: Sykesville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Sykesville, MD 21784
Phone (410) 991-2077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CWO15775PAMDClinical Social Worker
07971MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen Gumieny, LCSW Clinical CurrentSince Aug 24, 2012 Accepting new patients
Pinnacle Center for Mental Health & Human Relations LLC PastSince Feb 1, 2014 Accepting new patients

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1093785339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 RUDY SERRA DR UNIT 3A",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846552",
            "telephone_number": "410-991-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PIERCE ST",
            "address_2": "#305",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "410-991-2077",
            "fax_number": "570-696-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMIENNY",
        "first_name": "KATHLEEN",
        "middle_name": "KLEMER",
        "credential": "LCSW C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CWO15775",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "07971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.