Kimberly Back, LISW-S
NPI 1578923181ActiveIndividual· Social Worker, Clinical· Fairfield, OH
Social Worker, Clinical (LISW-S) in Fairfield, Ohio, trained at University of Cincinnati College of Medicine (class of 2012). Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1578923181 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LISW-S |
| Sole proprietor | No |
| NPI issued | Feb 25, 2016 |
| Last updated in NPPES | Oct 30, 2023 |
| Certified by provider | Oct 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | I.1451413 | OH |
| Counselor | 101Y00000X | LICDC.161918 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (OH) |
|---|
Education and affiliations
| Medical school | University of Cincinnati College of Medicine |
|---|---|
| Graduation year | 2012 |
| Medicare specialty | Clinical Social Worker |
Medical group
- Decoach Team LLCFairborn, OH · 17 clinicians
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