Kathryn Caudill, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2304275-SUPV Issued in OH

Practice address

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205

Phone

(513) 939-0300

NPI assigned

Aug 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Kathryn Daugherty Former name

Medicare fee-for-service enrollment

Enrolled in OH, KY2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindfully, LLC

  • Counselor
  • Fairfield, OH
  • NPI 1972702520

  Social Worker

  Medicare reassignment NPD
• Mindfully, LLC

  • Counselor
  • Louisville, KY
  • NPI 1891433975
  Medicare reassignment
• Mindfully Psychiatry LLC

  • Psychiatry Physician
  • Montgomery, OH
  • NPI 1881341543
  NPD (past)

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1679129373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "OH",
            "postal_code": "451031920",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "253359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304275-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DAUGHERTY",
            "prefix": "MISS",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rob Jay Cartwright, D.C., C.C.S.P
• Cheri Casey
• Lauren Ann Casey, PT
• Esther Cash-Mills, LCSW
• Thomas J. Catalanotto, M.D
• Amanda Cavanaugh
• Latosha Cecil
• Centers for Foot & Ankle Care LLC
• Susan Marie Cha, MD
• James Chaillet, MD

• Clinical Social Worker in Fairfield, OH
• Providers in Fairfield, 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 Dec 16, 2024; 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.