Individual provider Active NPI

Caitlin Phillips, LISW

  • Clinical Social Worker
  • Shelby, OH
National Provider Identifier
1114548609
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2305019 Issued in OH
Practice address
2775 State Route 39
Shelby, OH 44875-9466
Phone
(419) 747-3322
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1701375 OH
Clinical Social Worker 1041C0700X I.2305019 OH Primary

Addresses

Primary practice location

2775 State Route 39
Shelby, OH 44875-9466

Mailing address

2775 State Route 39
Shelby, OH 44875-9466
Phone (419) 747-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1701375OHMDSocial Worker
I.2305019OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Abraxas Group, LLC PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1114548609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CAITLIN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701375",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2305019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, OH

Sources for this page

Verify at the official NPI Registry.