Individual provider Active NPI

Kylie Stickel, LCSW

  • Clinical Social Worker
  • Fairbanks, AK
National Provider Identifier
1851274773
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
240480 Issued in AK
Practice address
3180 Peger Rd Ste 170
Fairbanks, AK 99709-5486
Phone
(907) 370-7878
NPI assigned
Jul 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 240480 AK Primary

Addresses

Primary practice location

3180 Peger Rd Ste 170
Fairbanks, AK 99709-5486

Mailing address

PO Box 81018
Fairbanks, AK 99708-1018
Phone (907) 650-7126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20251015000868 AK Practitioner - Clinical Social Worker 9436646205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3180 Peger Rd
Suite 170
Fairbanks, AK 99709-5484

609 Main St
Warsaw, OH 43844-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1851274773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81018",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997081018",
            "telephone_number": "907-650-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 PEGER RD STE 170",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095486",
            "telephone_number": "907-370-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKEL",
        "first_name": "KYLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "240480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.