Kathryn Marie Vicks, MSW, LISW-S, LCDC II

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.0800182-SUPV Issued in OH

Practice address

15 Trail Edge Cir
Powell, OH 43065-9464

Phone

(614) 561-5261

NPI assigned

Aug 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, AZ2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  OH

  Medicare reassignment Care Compare group
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, Clinical, OH

  Medicare reassignment NPD
• Fleximind Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Powell, OH
  • NPI 1396601274
  NPD Authorized official

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1285742395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TRAIL EDGE CIR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659464",
            "telephone_number": "614-561-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TRAIL EDGE CIR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659464",
            "telephone_number": "614-561-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKS",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW-S, LCDC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "21344",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1141581",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800182-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert B Vancourt, DPM
• Suma Vasantha
• Dawn Durrett Vass
• Annette Vernon
• Karen Stateler Veve, PT
• Village Medical Office Inc
• Matthew M Vincler, D.C.
• Vishal Chitkara DDS LLC
• Vitality Powell, LLC
• Janet E Volen, DNP RN NP-C

• Clinical Social Worker in Powell, OH
• Providers in Powell, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.