Individual provider Active NPI

Marilyn Catharine Kisiel, L.C.S.W.

  • Clinical Social Worker
  • Clearwater, FL
National Provider Identifier
1619950268
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 1534 Issued in FL
Practice address
2748 Sea Pines Cir E
Clearwater, FL 33761-3007
Phone
(727) 724-1965
Fax
(727) 239-7765
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 1534 FL Primary

Addresses

Primary practice location

2748 Sea Pines Cir E
Clearwater, FL 33761-3007

Mailing address

2748 Sea Pines Cir E
Clearwater, FL 33761-3007
Phone (727) 724-1965

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 1534FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin N Cohen PHD PA Past Accepting new patients
R Randolph Butts PSYD PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619950268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 SEA PINES CIR E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613007",
            "telephone_number": "727-724-1965",
            "fax_number": "727-239-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 SEA PINES CIR E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613007",
            "telephone_number": "727-724-1965",
            "fax_number": "727-239-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISIEL",
        "first_name": "MARILYN",
        "middle_name": "CATHARINE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 1534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.