Individual provider Active NPI

Kimberly L Hutchings, MSW, LISW-S

  • Clinical Social Worker
  • Boardman, OH
National Provider Identifier
1245595545
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.08000097-S Issued in OH
Practice address
5500 Market St
Suite 106
Boardman, OH 44512-2601
Phone
(330) 788-1155
Fax
(330) 788-1467
NPI assigned
Jul 12, 2012
Last updated
Jul 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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 I.08000097-S OH Primary

Addresses

Primary practice location

5500 Market St
Suite 106
Boardman, OH 44512-2601

Mailing address

5500 Market St
Suite 106
Boardman, OH 44512-2601
Phone (330) 788-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130924000906 OH Practitioner - Clinical Social Worker 3072757400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.08000097-SOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Village Network CurrentSince Aug 26, 2013 Accepting new patients
Village Network CurrentSince Aug 26, 2013 Accepting new patients

Locations

2000 Noble Dr
Wooster, OH 44691
Phone (330) 439-8492

3011 Akron Rd
Wooster, OH 44691
Phone (330) 202-3809

2401 Belmont Ave
Youngstown, OH 44505
Phone (330) 743-1015

5500 Market St
Ste 106
Youngstown, OH 44512
Phone (330) 623-5387

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1245595545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 106",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-788-1155",
            "fax_number": "330-788-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 106",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-788-1155",
            "fax_number": "330-788-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINGS",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.08000097-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.