Kristina Michelle Zettler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149012637 Issued in IL

Practice address

201 N 27TH St
Mount Vernon, IL 62864-2941

Phone

(618) 242-5614

NPI assigned

Jun 15, 2011

Last updated

Jun 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1043505241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N 27TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642941",
            "telephone_number": "618-242-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N 27TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642941",
            "telephone_number": "618-242-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZETTLER",
        "first_name": "KRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cesar G Yu, M.D.
• Evelyn B Yu, MD
• Rabia Zahid, DO
• Kalyn Zeller, LCSW
• Steven J Zelman, M.D.
• Renee Zoll, QMHP
• Colin Zuber, ATC

• Clinical Social Worker in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.