NPIMap

Individual provider Active NPI

Kaylee Fisher, LMSW, LCSW

  • Clinical Social Worker
  • Olive Branch, MS
National Provider Identifier
1932734159
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009190 Issued in GA
Practice address
5739 Blocker St
Olive Branch, MS 38654-3051
Phone
(269) 625-6885
NPI assigned
Mar 9, 2020
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW009838 GA
Social Worker 104100000X M10029 MS
Clinical Social Worker 1041C0700X CSW009190 GA Primary

Addresses

Primary practice location

5739 Blocker St
Olive Branch, MS 38654-3051

Mailing address

5739 Blocker St
Olive Branch, MS 38654-3051
Phone (269) 625-6885

Other names 1

  • Kaylee Waldron Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MSW009838GAMDSocial Worker
M10029MSMDSocial Worker
CSW009190GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Christian Services of Georgia PastSince Mar 1, 2020 Accepting new patients
Bethany Christian Services PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1932734159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5739 BLOCKER ST",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543051",
            "telephone_number": "269-625-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5739 BLOCKER ST",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386543051",
            "telephone_number": "269-625-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KAYLEE",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW009838",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M10029",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEE",
            "last_name": "WALDRON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.