Carrie A Phillips, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0008753 Issued in OH

Practice address

500 Lincoln Park Blvd Ste 208
Kettering, OH 45429-3479

Phone

(937) 293-4199

Fax

(937) 298-6271

NPI assigned

Jan 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• South Suburban Mental Health Group

  • Clinical Social Worker
  • Centerville, OH
  • NPI 1013963065
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285784629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 208",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293479",
            "telephone_number": "937-293-4199",
            "fax_number": "937-298-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LINCOLN PARK BLVD STE 208",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293479",
            "telephone_number": "937-293-4199",
            "fax_number": "937-298-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CARRIE",
        "middle_name": "A",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0008753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000372382",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles D Peterson, MD
• Kesley Peterson, DO
• Mikhail Petrov
• Taylor Petry, M.S. CCC-SLP
• John Petty, MD
• Myah Phillips
• Michael Phipps
• Darrel Tan Phong, DO
• Patricia Pienaar, PA-C
• Thomas G Pierron

• Clinical Social Worker in Kettering, OH
• Providers in Kettering, 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 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.