Active NPI
Tabitha R Kersten
- Social Worker
- Defiance, OH
National Provider Identifier
1720594963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1802301
- Practice address
- 511 Perry St
Defiance, OH 43512-2123 - Phone
- (419) 782-9920
- Fax
- (419) 784-2523
- NPI assigned
- Dec 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Social Worker | 104100000X | S.1802301 | OH | Primary |
Addresses
Primary practice location
511 Perry St
Defiance, OH 43512-2123
Mailing address
511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164318 | Other | OH | LICENSE |
| S.1802301 | Other | OH | COUNSELOR, SOCIAL WORKER AND MFT BOARD |
Other names 1
- Tabitha R Del Carmen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1802301 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Services of Northwest Ohio, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/rsnwo/r4/
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.
-
- Clinic/Center
- Defiance, OH
- NPI 1720046451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1720594963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-782-9920",
"fax_number": "419-784-2523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-782-9920",
"fax_number": "419-784-2523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSTEN",
"first_name": "TABITHA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-26",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1802301",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "164318",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNSELOR, SOCIAL WORKER AND MFT BOARD",
"identifier": "S.1802301",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TABITHA",
"last_name": "DEL CARMEN",
"middle_name": "R",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.