Individual provider Active NPI

Destonie Dawn Cormier

  • Clinical Social Worker
  • Westerville, OH
National Provider Identifier
1710348933
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2506469 Issued in OH
Practice address
623 Park Meadow Rd Ste H
Westerville, OH 43081-2876
Phone
(614) 948-3273
Fax
(855) 740-2025
NPI assigned
Mar 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2506469 OH Primary
Social Worker 104100000X 093084 NY

Addresses

Primary practice location

623 Park Meadow Rd Ste H
Westerville, OH 43081-2876

Mailing address

5011 Pine Creek Dr
Westerville, OH 43081-4849
Phone (614) 948-3273

Other practice location 1

4 Fuller St
Alexandria Bay, NY 13607-1316
Phone (315) 482-1256

Other names 1

  • Destonie Dawn Kimpton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250729001576 OH Practitioner - Clinical Social Worker 5597173427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Serenity Behavioral Health Services, Inc.Group PAC ID 6002164845, 15 clinicians

Practice addresses (Care Compare)

623 Park Meadow Rd
Suite H
Westerville, OH 43081-2876
Phone (614) 948-3273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093084NYMDSocial Worker
I.2506469OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Behavioral Health Services, Inc. CurrentSince Jul 15, 2025 Accepting new patients

Locations

495 E Mound St
Ste 110
Columbus, OH 43215
Phone (614) 948-3273

623 Park Meadow Rd
Ste H
Westerville, OH 43081
Phone (614) 774-1120

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1710348933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 PINE CREEK DR",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814849",
            "telephone_number": "614-948-3273",
            "fax_number": "855-740-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 PARK MEADOW RD STE H",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812876",
            "telephone_number": "614-948-3273",
            "fax_number": "855-740-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Fuller St",
            "address_purpose": "LOCATION",
            "city": "Alexandria Bay",
            "state": "NY",
            "postal_code": "136071316",
            "country_code": "US",
            "telephone_number": "315-482-1256",
            "fax_number": "315-482-4911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "DESTONIE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2506469",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESTONIE",
            "last_name": "KIMPTON",
            "middle_name": "DAWN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.