Judith Lynne Kellermeier, L.I.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0600027 Issued in OH

Practice address

1616 E Wooster St
Suite 24
Bowling Green, OH 43402-3478

Phone

(419) 352-4624

Fax

(419) 354-1774

NPI assigned

Aug 23, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1780877605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STRANAHAN SQ",
            "address_2": "SUITE 414",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041447",
            "telephone_number": "419-244-5511",
            "fax_number": "419-321-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 E WOOSTER ST",
            "address_2": "SUITE 24",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434023478",
            "telephone_number": "419-352-4624",
            "fax_number": "419-354-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMEIER",
        "first_name": "JUDITH",
        "middle_name": "LYNNE",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0600027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bowling Green, OH
• Providers in Bowling Green, 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 Aug 23, 2007; 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.