Kaitlin G Fibkins, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098111 Issued in NY

Practice address

31 Industrial Blvd
Medford, NY 11763-2220

Phone

(631) 924-4411

NPI assigned

May 7, 2021

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Yaphank Center

  • Community/Behavioral Health Agency
  • Medford, NY
  • NPI 1790147411
  NPD (past)

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1164006060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 EVERGREEN AVE",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401539",
            "telephone_number": "631-875-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-924-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Main St Ste 508",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012680",
            "country_code": "US",
            "telephone_number": "631-727-6220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIBKINS",
        "first_name": "KAITLIN",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "11210101",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE",
            "identifier": "11210101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony William Fazio, DDS
• Karen M Feldmann, M.T.
• Ferguson and Pitch TMS Medical Associates PLLC
• Frank Ferrara
• Olivia Ann Fertmann
• Karen Constance Field, NURSE PRACTITIONER
• Zachary Fisher
• Chaise Flaherty
• Bevin Ann Flemming
• Lizett Flores

• Clinical Social Worker in Medford, NY
• Providers in Medford, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.