Individual provider Active NPI

Kali Mitchell

  • Clinical Social Worker
  • Old Washington, OH
National Provider Identifier
1972229581
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.2101827-TRNE Issued in OH
Practice address
239A Old National Rd
Old Washington, OH 43768
Phone
(740) 489-5571
Fax
(740) 489-5004
NPI assigned
Oct 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X S.2101827-TRNE OH Primary

Addresses

Primary practice location

239A Old National Rd
Old Washington, OH 43768

Mailing address

PO Box 94
Old Washington, OH 43768-0094
Phone (740) 489-5571

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
S.2101827-TRNEOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Ohio Counseling Center, LLC. CurrentSince Oct 16, 2022 Accepting new patients
Southeastern Ohio Counseling Center, LLC. CurrentSince Oct 16, 2022 Accepting new patients

Locations

239A Old National Rd
Old Washington, OH 43768
Phone (740) 489-5571

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/southeasternohiocounseling/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1972229581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "OLD WASHINGTON",
            "state": "OH",
            "postal_code": "437680094",
            "telephone_number": "740-489-5571",
            "fax_number": "740-489-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239A OLD NATIONAL RD",
            "city": "OLD WASHINGTON",
            "state": "OH",
            "postal_code": "43768",
            "telephone_number": "740-489-5571",
            "fax_number": "740-489-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2101827-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Washington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.