Katrina Connell, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2304605 Issued in OH

Practice address

5563 Far Hills Ave
Dayton, OH 45429-2225

Phone

(937) 291-2300

Fax

(937) 291-2303

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Katie Knox LPCC, LLC

  dba Katie Knox & Associates Counseling Services

  • Professional Counselor
  • Saint Clairsville, OH
  • NPI 1992153456
  Medicare reassignment NPD
• Kav Health Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1891332946
  Medicare reassignment NPD

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1346728714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5563 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292225",
            "telephone_number": "937-291-2300",
            "fax_number": "937-291-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5563 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292225",
            "telephone_number": "937-291-2300",
            "fax_number": "937-291-2303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9403 Kenwood Rd Ste A130",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "452426880",
            "country_code": "US",
            "telephone_number": "513-543-6600",
            "fax_number": "513-745-0037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "KATRINA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "166548",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903328",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2304605",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "161761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333299",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Conley
• Sara Maureen Conley, CNP
• Jennifer Marie Conlon, MD
• Irene Conn, MS, RD, LD, CLC
• Connectivcare LLC
• Brian Connelly
• Patrick J Connelly, MD
• Amiya Conner
• Gary J Conner, MD
• Jason Conner

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, 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 Mar 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.