Individual provider Active NPI

Katherine Fitzsimmons, MSW, LSW

  • Clinical Social Worker
  • Dublin, OH
National Provider Identifier
1639723281
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1903945 Issued in OH
Practice address
5050 Blazer Pkwy Ste 201
Dublin, OH 43017-3361
Phone
(614) 353-9365
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 S.1903945 OH Primary

Addresses

Primary practice location

5050 Blazer Pkwy Ste 201
Dublin, OH 43017-3361

Mailing address

2050 Reilly Run Unit C
Grove City, OH 43123-9118
Phone (614) 353-9365

Other identifiers 1

IdentifierTypeStateIssuer
S.1903945OtherOHOHIO COUNSELOR, SOCIAL WORKER & MFT BOARD

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
S.1903945OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1639723281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 REILLY RUN UNIT C",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431239118",
            "telephone_number": "614-353-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 BLAZER PKWY STE 201",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173361",
            "telephone_number": "614-353-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "KATHERINE",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1903945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO COUNSELOR, SOCIAL WORKER & MFT BOARD",
            "identifier": "S.1903945",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.