Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Kathryn Marie Vicks, MSW, LISW-S, LCDCII

Individual provider Clinical Social Worker · NPI 1285742395

Mrs. Kathryn Marie Vicks, MSW, LISW-S, LCDCII is a Clinical Social Worker in Powell, Ohio. Qualified in 2006, 20 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona, Massachusetts and Ohio.

Years since qualifying
20
Licensed in
AZ, MA, OH
In the registry since
2006
Specialties on file
3
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.

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Practice location Address checks out

15 Trail Edge Cir
Powell, OH 43065-9464
Phone: (614) 561-5261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.0800182-SUPV (OH)
Clinical Social Worker Taxonomy 1041C0700X · Licence 21344 (AZ)
Clinical Social Worker Taxonomy 1041C0700X · Licence 1141581 (MA)

Record details

NPI number1285742395
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LISW-S , LCDCII
Sole proprietorNo
NPI enumeratedAugust 28, 2006
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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