MS. KELLIE RENEE COUSINO (LISW) – Social Worker, NPI 1295224897
Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,058 CLINICAL SOCIAL WORKER in GA
Provider Addresses for MS. KELLIE RENEE COUSINO (LISW)
115 AQUINNAH DR
POOLER, GA 313228277
Phone: (419) 217-2122
Type: Mailing
2005, Ashland Avenue, Collingwood Springs, Toledo, Lucas County, Ohio, 43620, United States
TOLEDO, OH 436201703
Phone: (419) 841-7701
Type: Mailing
2606 102ND ST
TOLEDO, OH 436112010
Phone: (419) 217-2122
Type: Mailing
1251 NILLES RD STE 5
FAIRFIELD, OH 450147205
Phone: (513) 939-0300
Fax: (513) 939-0310
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-09
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220817002014 | I | Clinical Social Worker | OH | TBD |
| I20230628004299 | I | Clinical Social Worker | SC | TBD |
| I20240809003214 | I | Clinical Social Worker | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31322)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Addiction Medicine | CA | |
| Internal Medicine | MI | |
| Clinical Social Worker | TX | |
| Internal Medicine, Addiction Medicine | CA | |
| Nurse Practitioner | NM | |
| Clinical Social Worker | WA |
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