Individual provider Active NPI

Kristin Marie Cipolla, LISW

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1386200137
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901454 Issued in OH
Practice address
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone
(440) 260-8300
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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.1901454 OH Primary

Addresses

Primary practice location

3500 Carnegie Ave
Cleveland, OH 44115-2641

Mailing address

10605 Greenhaven Pkwy
Brecksville, OH 44141-1628

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901454OHMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: kcipolla33303@ehrdirect.uhhospitals.org

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1386200137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 GREENHAVEN PKWY",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIPOLLA",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.