Courtney Danielle Kisamore, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00946369 Issued in WV

Practice address

120 Professional PL Ste 101
Bridgeport, WV 26330-4599

Phone

(304) 513-3495

NPI assigned

Nov 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• GR&W, Inc

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  NPD (past)

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1699484014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PEMBROKE CT",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016404",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL PL STE 101",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304599",
            "telephone_number": "304-513-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6510 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265018525",
            "country_code": "US",
            "telephone_number": "304-557-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Dunbar St",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "PA",
            "postal_code": "154014275",
            "country_code": "US",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Walnut Ave",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265542821",
            "country_code": "US",
            "telephone_number": "724-396-1510",
            "fax_number": "724-972-4627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISAMORE",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00946369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699484014",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie R King-Selario, DO
• Richard Wade King, M.D.
• Susan Rennae Kirkendall, MS,AADC
• Mara Alexis Kirkpatrick
• Padraig Kirkwood
• Christina Kitsos, M.D.
• Eleni Kitsos, M.D.
• Amber Nicole Klema, LCSW
• Gracee Klingensmith
• Klpnp LLC

• Social Worker in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.