Kimberly Altick, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1700446 Issued in OH

Practice address

257 Hopeland St BLDG a
Dayton, OH 45417-3420

Phone

(937) 245-6119

NPI assigned

Oct 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1972931350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 HOPELAND ST BLDG A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173420",
            "telephone_number": "937-367-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 HOPELAND ST BLDG A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173420",
            "telephone_number": "937-245-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTICK",
        "first_name": "KIMBERLY",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Alt, RPH
• Majdoleen Marie Altahtamoni, QMHS 3YRS CMS
• Megan Elizabeth Altekruse
• Sherman John Alter, MD
• Kelly Lee Altic, LSW
• Christopher D Altman, PHARMD, RPH
• Whitney Altman, MEDICAL ASSISTANT
• Nicholas Altvater, ATS
• Ebenezer Aluma, PA
• Mohamed Kazim Alwani, M.D.

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, 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 Sep 19, 2024; 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.