Kimberly Antonides, LSW
Individual provider Active NPI Social Worker · Troy, OH
NPI 1699224592 · NPPES record last updated Oct 3, 2016
Key facts
- NPI
- 1699224592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S17668 (OH)
- Practice address
- 550 Summit Ave
Troy, OH 45373-3047 - Phone
- (937) 335-0361
- NPI assigned
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S17668 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Darke County Mental Health Clinic, Inc | Past | Accepting new patients | |
| Darke County Recovery Services | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/recoveryandwellnessohio/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S17668 | OH | Yes |
Addresses
Primary practice location
550 Summit Ave
Troy, OH 45373-3047
Mailing address
550 Summit Ave
Troy, OH 45373-3047
Phone (937) 335-0361
Other providers in Troy, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.