KIM P STANELUIS (LISW LICDC) – Social Worker, NPI 1770657579

KIM P STANELUIS (LISW LICDC) is a healthcare provider. based in Maumee, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW LICDC. They hold a License No. I0001046 (OH). The NPI Number for KIM P STANELUIS (LISW LICDC) is 1770657579

Main info

Female
55 Years Of Experience
Accepts Medicare Assignment
Name
KIM P STANELUIS (LISW LICDC)
NPI
1770657579
Phone
(419) 893-8432
Address
109 W WAYNE ST
Enumeration Date
20 November 2006
Last Update Date
14 June 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4198938432
Graduation Year
1971 (55 years ago)
PAC ID
4688745284
Group Practice PAC ID
9133290737
Professional Enrollment ID
I20080625000015
Address ID
OH435372150MA109XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

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Provider Addresses for KIM P STANELUIS (LISW LICDC)

  • 109, West Wayne Street, Maumee Uptown Historic District, Maumee, Lucas County, Ohio, 43537, United States

    MAUMEE, OH 435372150

    Phone: (419) 893-8432

    Fax: (419) 891-5403

    Mailing address matches the actual address.

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: 2008-06-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080625000015IClinical Social WorkerOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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 43537)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133290737View full group profile
NameSpecialtyState
Mental Health CounselorOH

Reviews

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Frequently asked questions

Does KIM P STANELUIS (LISW LICDC) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KIM P STANELUIS (LISW LICDC) uses 1770657579.
Does the file indicate KIM P STANELUIS (LISW LICDC) is practicing under active NPI?
Directory data currently reports KIM P STANELUIS (LISW LICDC) as active.
What is KIM P STANELUIS (LISW LICDC)'s specialty?
The listing groups KIM P STANELUIS (LISW LICDC) with Social Worker. Clinical services aligned with this taxonomy classification.
Where is KIM P STANELUIS (LISW LICDC) based?
KIM P STANELUIS (LISW LICDC) is tied to Maumee, Ohio in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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