Individual provider Active NPI

Kairo Vivas, LCSW-C

  • Clinical Social Worker
  • Pikesville, MD
National Provider Identifier
1407124217
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17447 Issued in MD
Practice address
8 Reservoir Cir Ste 105
Pikesville, MD 21208-6362
Phone
(202) 670-3704
NPI assigned
Dec 7, 2011
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17447 MD Primary
School Social Worker 1041S0200X LC50081219 DC

Addresses

Primary practice location

8 Reservoir Cir Ste 105
Pikesville, MD 21208-6362

Mailing address

8 Reservoir Cir Ste 105
Pikesville, MD 21208-6362
Phone (202) 250-9008

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC50081219DCMDSchool Social Worker
17447MDMDOrthopedic Physical Therapist

Organizations & group practices 1

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": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1407124217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RESERVOIR CIR STE 105",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086362",
            "telephone_number": "202-250-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RESERVOIR CIR STE 105",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086362",
            "telephone_number": "202-670-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVAS",
        "first_name": "KAIRO",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17447",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "DC",
            "license": "LC50081219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.