Active NPI
Katie Lynn Bradshaw, LISW
- Clinical Social Worker
- Dayton, OH
National Provider Identifier
1164918793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.2506999
- Practice address
- 4100 W 3Rd St BLDG 330
Dayton, OH 45428-9000 - Phone
- (937) 268-6511
- NPI assigned
- Jul 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.2506999 | OH | Primary |
Addresses
Primary practice location
4100 W 3Rd St BLDG 330
Dayton, OH 45428-9000
Mailing address
4100 W 3Rd St BLDG 330
Dayton, OH 45428-9000
Phone (937) 268-6511
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.2506999 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homefull | Past | 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.
-
- Case Management Agency
- Dayton, OH
- NPI 1598786667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1164918793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 W 3RD ST BLDG 330",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W 3RD ST BLDG 330",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "KATIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-06",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.2506999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.