Octavia C Kemps, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7121123 Issued in WI

Practice address

25 Kessel CT
Ste 105
Madison, WI 53711-6227

Phone

(608) 280-2440

Fax

(608) 280-2655

NPI assigned

Nov 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Phoenix Counseling, LTD

  • Clinical Social Worker
  • Sun Prairie, WI
  • NPI 1235263427
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1851465124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 HOOVER ST",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535752834",
            "telephone_number": "608-280-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT",
            "address_2": "STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2440",
            "fax_number": "608-280-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPS",
        "first_name": "OCTAVIA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7121123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40983000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Kemp, PT
• William J Kemp III, MD
• Matthew J Kempfer, NP
• Jonathan David Kempfert, PHARMD
• Brittany Page Kempinski, AU.D.
• Steven J Kempton, M.D.
• Aria Kenarsary, MD
• Michelle L Kenas
• Cameron Richardson Kendall, M.D.
• Emerson Kendall, DO

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.