Individual provider Active NPI

Anita R Kiessling-Caver, LCSW

  • Clinical Social Worker
  • Moberly, MO
National Provider Identifier
1164599692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW004543 Issued in MO
Practice address
811 S 5TH St
Moberly, MO 65270-1872
Phone
(660) 263-7044
Fax
(660) 263-8857
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SW004543 MO Primary

Addresses

Primary practice location

811 S 5TH St
Moberly, MO 65270-1872

Mailing address

811 S 5TH St
Moberly, MO 65270-1872
Phone (660) 263-7044

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW004543MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164599692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S 5TH ST",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652701872",
            "telephone_number": "660-263-7044",
            "fax_number": "660-263-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S 5TH ST",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652701872",
            "telephone_number": "660-263-7044",
            "fax_number": "660-263-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESSLING-CAVER",
        "first_name": "ANITA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW004543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.