Kimberly G. Markham, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1700662 Issued in OH

Practice address

36 N Detroit St Ste 105
Sugarcreek Township, OH 45385-2963

Phone

(937) 610-4673

Fax

(937) 736-2615

NPI assigned

Oct 23, 2017

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Decoach Team LLC

  dba DeCoach Rehabilitation Centre

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  NPD
• Psycho Social Therapies,LTD

  • Clinical Social Worker
  • Beachwood, OH
  • NPI 1750335261
  NPD
• Psycho Social Therapies,LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beachwood, OH
  • NPI 1902462906
  NPD
• Decoach Team LLC

  dba DeCoach Rehabilitation Centre

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD (past)
• Oesterlen Services for Youth, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Springfield, OH
  • NPI 1740244284
  NPD (past)

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1659882264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 N DETROIT ST STE 105",
            "city": "SUGARCREEK TOWNSHIP",
            "state": "OH",
            "postal_code": "453852963",
            "telephone_number": "937-610-4673",
            "fax_number": "937-736-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N DETROIT ST STE 105",
            "city": "SUGARCREEK TOWNSHIP",
            "state": "OH",
            "postal_code": "453852963",
            "telephone_number": "937-610-4673",
            "fax_number": "937-736-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "KIMBERLY",
        "middle_name": "G.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley Ferer, PA-C
• Rahaf Ghentawi
• Deanna G Juin, ED.S., NCSP
• Life Development Centers, Incorporated (Stephen W Emerick PhD and Associates)
• Laura Alice Little, LSW
• Parag Modi, DMD
• Kyle Donovan Oswalt, MA, HCA
• Hannah Smith
• Elizabeth Mary Ulrich, MS

• Clinical Social Worker in Sugarcreek Township, OH
• Providers in Sugarcreek Township, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.