Individual provider Active NPI

Christine C Kissner, LMSW

  • Social Worker
  • Baltimore, MD
National Provider Identifier
1548046303
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
30524 Issued in MD
Practice address
4128 Hayward Ave
Baltimore, MD 21215-4340
Phone
(410) 314-1030
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 30524 MD Primary

Addresses

Primary practice location

4128 Hayward Ave
Baltimore, MD 21215-4340

Mailing address

5131 Benton Heights Ave
Baltimore, MD 21206-5007
Phone (410) 967-3717

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
30524MDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1548046303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 BENTON HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065007",
            "telephone_number": "410-967-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 HAYWARD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154340",
            "telephone_number": "410-314-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSNER",
        "first_name": "CHRISTINE",
        "middle_name": "C",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "30524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.