Kidsheart Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.0008990 Issued in OH

Legal business name

KIDSHEART COUNSELING, LLC

Practice address

463 Allenby Dr
Marysville, OH 43040-8521

Phone

(937) 209-0088

NPI assigned

Nov 14, 2017

Organization subpart

No

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

Authorized official

Name

Charity A Detrick, LISWNPI 1326019134

Title

Owner

Phone

(937) 209-0088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charity A Detrick, LISW

  • Clinical Social Worker
  • Marysville, OH
  • NPI 1326019134
  Medicare reassignment NPD Authorized official
• Susan Swayze, LPCC - S

  • Professional Counselor
  • Dublin, OH
  • NPI 1548492812
  NPD (past)

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1467965335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 BROOKSTONE DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408743",
            "telephone_number": "937-642-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 ALLENBY DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430408521",
            "telephone_number": "937-209-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSHEART COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "CHARITY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-209-0088",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0008990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Allen Kennedy, DDS
• Larry D Kennedy, DDS
• Kristen Louise Kennison, MA CCC-SLP
• Christa Kerns, CNP
• Kevin Grill DDS Marysville LLC
• Scott W Kijowski, RPH
• Jennifer Lynn Kile
• Breanna Kinn
• Abby Kinstle
• Cheryl K Kirkby, MD

• Clinical Social Worker in Marysville, OH
• Providers in Marysville, 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 Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.