Kimberly Rae Patton, LISW-S, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1100087-SUPV Issued in OH

Practice address

140 Wadsworth Rd
Wadsworth, OH 44281-9503

Phone

(440) 623-3845

NPI assigned

Jan 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1518474618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 ROEPER RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441346100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WADSWORTH RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819503",
            "telephone_number": "440-623-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "credential": "LISW-S, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1100087-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Thomas Parsons, MOT, OTR/L
• Partners Physician Group
• Partners Physician Group
• Rachel N Patel, M.D.
• Ronak Bimal Patel
• Rikki Patton, PHD
• Jillian Deena Pelland, OTR/L
• Christina M Peters, D.O.
• Tanya Peters
• Kyle Petruzzi

• Clinical Social Worker in Wadsworth, OH
• Providers in Wadsworth, 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 Jan 10, 2018; 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.