Kathleen Christine Dart, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Winterville, GA
NPI 1568622256 · NPPES record last updated Mar 4, 2025
Key facts
- NPI
- 1568622256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801089802 (MI)
- Practice address
- 14 Pecan CT
Winterville, GA 30683-2325 - Phone
- (517) 285-9165
- NPI assigned
- Jun 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100623000541 | MI | Practitioner - Clinical Social Worker | 1052442894 | Reassigns benefits to 1 organization |
| I20240809002959 | GA | Practitioner - Clinical Social Worker | 1052442894 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW007053 | GA | MD | Clinical Social Worker |
| 6801089802 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current |
Accepting new patients |
| KCD Counseling | Clinical | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616
4131 Okemos Rd
Ste 10
Okemos, MI 48864
Phone (517) 282-0792
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801089802 | MI | Yes |
| Clinical Social Worker | 1041C0700X | CSW007053 | GA |
Addresses
Primary practice location
14 Pecan CT
Winterville, GA 30683-2325
Mailing address
14 Pecan CT
Winterville, GA 30683-2325
Phone (172) 859-1655
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12118724 | Other | CAQH |
Other providers in Winterville, GA
- Marc Castelo
- Cornerstone EMS LLC
- Crew Consulting Services LLC
- Nikki Crew
- Jane Michelle Culp
- Dental Sleep Medicine of Athens, LLC
- Phillip Hue Durden IV
- Flourish Therapy Service, LLC
- Gayle Robbins PHD LLC
- Kelli Leigh Gunn
All providers in Winterville, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.