Individual provider Active NPI

Kathryn Maimone, LISW-S

  • Clinical Social Worker
  • Lorain, OH
National Provider Identifier
1104285063
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0800194-SUPV Issued in OH
Practice address
6140 S Broadway
Lorain, OH 44053-3821
Phone
(440) 204-4228
Fax
(440) 233-9070
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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 I0800194-SUPV OH Primary

Addresses

Primary practice location

6140 S Broadway
Lorain, OH 44053-3821

Mailing address

6140 S Broadway
Lorain, OH 44053-3821
Phone (440) 204-4228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160331002722 OH Practitioner - Clinical Social Worker 7517264823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0800194-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Riveon Mental Health and Recovery CurrentSince Feb 1, 2016 Accepting new patients
Riveon Mental Health and Recovery CurrentSince Feb 1, 2016 Accepting new patients

Locations

6140 S Broadway
Lorain, OH 44053
Phone (440) 233-7232

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": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1104285063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-204-4228",
            "fax_number": "440-233-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-204-4228",
            "fax_number": "440-233-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIMONE",
        "first_name": "KATHRYN",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0800194-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.