Kaitlyn Jo Sparks, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1700159 Issued in OH

Practice address

4761 State Route 29
Celina, OH 45822-8216

Phone

(419) 584-1000

NPI assigned

Dec 6, 2017

Sex

Female

Sole proprietor

No

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

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/choicesohio/r4/

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.

• Children Have Options in Caring Environments

  • Community/Behavioral Health Agency
  • Dayton, OH
  • NPI 1861798662
  NPD (past)
• Foundations Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Celina, OH
  • NPI 1336118330
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1619482114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4761 STATE ROUTE 29",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458228216",
            "telephone_number": "419-584-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4761 STATE ROUTE 29",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458228216",
            "telephone_number": "419-584-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1785 Big Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454392219",
            "country_code": "US",
            "telephone_number": "937-264-0084 x136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KAITLYN",
        "middle_name": "JO",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1700159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Kimberly Smith
• Jenni Smith, COTA/L
• Julia M Smith, LPCC
• Kimberley M Smith
• Sydney Michelle Snyder, APRN-CNP
• Cheri Spear
• Kelsey Speck, PT, DPT
• Marisa Spoltman, PA
• Christi Stacey
• McAla Starr

• Social Worker in Celina, OH
• Providers in Celina, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.