Active NPI
Kathleen Civitello
- Occupational Therapist
- Havertown, PA
National Provider Identifier
1164966917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 312 Maryland Ave
Havertown, PA 19083-3013 - Phone
- (610) 639-4875
- NPI assigned
- Dec 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
312 Maryland Ave
Havertown, PA 19083-3013
Mailing address
312 Maryland Avenue
Havertown, PA 19083
Phone (610) 639-4875
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634083200000",
"number": "1164966917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 MARYLAND AVENUE",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "19083",
"telephone_number": "610-639-4875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 MARYLAND AVE",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190833013",
"telephone_number": "610-639-4875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIVITELLO",
"first_name": "KATHLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-13",
"last_updated": "2021-10-13",
"certification_date": "2021-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havertown, PA
- Chin-Suk John Cho, D.C, DACBR, RMSK
- Yoon-Jung Dianna Cho, O.D.
- Ul Sik Jason Chong, DOCTORATE OF PHARMAC
- Larry H Chou, M.D.
- Christiana Care Havertown ASC, LLC
- Patricia Ann Clancy, M.D.
- Stacina Elizabeth Clark, LPC
- Kathleen Clarke, LPC, MBA, CAADC
- Kelly Anne Clarke, MSW
- Classic Physical Therapy and Rehab Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.