Katie M Kissel, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901950-SUPV Issued in OH

Practice address

4312 Bowman Street Rd
Shelby, OH 44875-8806

Phone

(419) 612-1821

NPI assigned

Sep 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hope419 LLCGroup PAC ID 8022506930, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hope419, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Ontario, OH
  • NPI 1750990438
  Medicare reassignment Care Compare group NPD
• Hope419, LLC

  dba Hope419

  • Psychiatry Physician
  • Ontario, OH
  • NPI 1184375628
  NPD

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1821546953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 BOWMAN STREET RD",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448758806",
            "telephone_number": "419-612-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 BOWMAN STREET RD",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448758806",
            "telephone_number": "419-612-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "KATIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1440189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901950-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Kalombo Ngoy
• Joshua Kemp
• Valerie Kennedy
• Keunsun Lew MD Inc
• Maurice King III
• Laura Ann Kline, CDCA
• Tanya Kraus, LSW
• Michelle Y Krietemeyer, RPH
• Jamie Linn Ladd, NP-C
• Timothy Lafferty, LSW

• Clinical Social Worker in Shelby, OH
• Providers in Shelby, 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 Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.