Keisha Pettijohn

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2601 Melrose Ave
Cincinnati, OH 45206-1601

Phone

(513) 549-4172

NPI assigned

Apr 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fatherhood Revisited

  • Case Management Agency
  • Blue Ash, OH
  • NPI 1144762337
  NPD Authorized official

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1528487154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12685",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452120685",
            "telephone_number": "513-549-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 MELROSE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061601",
            "telephone_number": "513-549-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIJOHN",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary B Petrie, DDS
• Kristin Nicole Petrosky, P.T.
• Hannah Lee Pettibone, DO
• Courtney Pettiford, LSW
• Samuel Charles Pettigrew, MD
• Precious Pettijohn
• Amanda Pettis, M.A., CCC-A
• Michaela E Pettis
• Sharde Bryaun Pettis, M.A.
• Chappel Cronier Pettit, MD

• Clinical Social Worker in Cincinnati, OH
• Providers in Cincinnati, 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 5, 2020; 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.