Kalyn Black, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901814 Issued in OH

Practice address

3333 Burnet Avenue
MLC 3014
Cincinnati, OH 45229-3026

Phone

(513) 636-4788

Fax

(513) 517-0860

NPI assigned

Jun 7, 2016

Last updated

Jan 6, 2020By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Hospital Medical Center

  dba Cincinnati Children's Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784

  Social Worker

  Medicare reassignment NPD

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1912356361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "MLC 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4788",
            "fax_number": "513-517-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "MLC 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4788",
            "fax_number": "513-517-0860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4966 Glenway Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383905",
            "country_code": "US",
            "telephone_number": "513-706-5318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4966 Glenway Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383905",
            "country_code": "US",
            "telephone_number": "513-706-5318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Cincinnati Batavia Pike",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452441557",
            "country_code": "US",
            "telephone_number": "513-752-1555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Cincinnati Batavia Pike",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452441557",
            "country_code": "US",
            "telephone_number": "513-752-1555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4629 Aicholtz Road",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45244",
            "country_code": "US",
            "telephone_number": "513-752-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KALYN",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1502337",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Carroll Black, D.O.
• Erin Louise Black, CNP
• Jasenka D Black, LISW-S
• Jayonna Kemorya Black
• John Joseph Black Jr., RPH
• Kathryn Black
• Khadijallah Black
• Latosha Black
• Myeashia Black
• Nancy E Black, CRNA

• Clinical Social Worker in Cincinnati, OH
• Providers in Cincinnati, 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 Jan 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.