Individual provider Active NPI

Kimberlee A Kiefer, LSW

  • Social Worker
  • Canton, OH
National Provider Identifier
1982474722
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S0030140 Issued in OH
Practice address
624 Market Ave N
Canton, OH 44702-1017
Phone
(330) 493-4553
Fax
(330) 493-3761
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X S0030140 OH Primary

Addresses

Primary practice location

624 Market Ave N
Canton, OH 44702-1017

Mailing address

624 Market Ave N
Canton, OH 44702-1017
Phone (330) 493-4553

Other names 1

  • Kimberlee A McCall-Kiefer 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
S0030140OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1982474722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021017",
            "telephone_number": "330-493-4553",
            "fax_number": "330-493-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021017",
            "telephone_number": "330-493-4553",
            "fax_number": "330-493-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEFER",
        "first_name": "KIMBERLEE",
        "middle_name": "A",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0030140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEE",
            "last_name": "MCCALL-KIEFER",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.