Individual provider Active NPI

Kelly Capitini, SWT

  • Social Worker
  • Newark, OH
National Provider Identifier
1467113522
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2309072 Issued in OH
Practice address
68 W Church St Ste 318
Newark, OH 43055-5050
Phone
(740) 687-0042
NPI assigned
Dec 31, 2021
Last updated
May 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2309072 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X S.2102254 OH

Addresses

Primary practice location

68 W Church St Ste 318
Newark, OH 43055-5050

Mailing address

780 Jonathan LN
Newark, OH 43055-1734
Phone (347) 327-0107

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251107002791 OH Practitioner - Clinical Social Worker 6507356425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Ohio Psychological Services, IncGroup PAC ID 3577585819, 12 clinicians

Practice addresses (Care Compare)

106 Starret St
Suite 100
Lancaster, OH 43130-3993
Phone (740) 687-0042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.2309072OHMDSocial Worker
S.2102254OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Ohio Psychological Services Inc Social Worker CurrentSince Aug 29, 2025 Accepting new patients
Mid-Ohio Psychological Services Inc Social Worker CurrentSince Aug 29, 2025 Accepting new patients

Locations

106 Starret St
Ste 100
Lancaster, OH 43130
Phone (740) 687-0042

Organizations & group practices 2

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": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1467113522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 JONATHAN LN",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551734",
            "telephone_number": "347-327-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 318",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-687-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPITINI",
        "first_name": "KELLY",
        "credential": "SWT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2309072",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "S.2102254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.