Active NPI
Crystal Weckert
- Clinical Social Worker
- Onamia, MN
National Provider Identifier
1043551310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17509
- Practice address
- 18562 Minobimaadizi Loop
Onamia, MN 56359-3001 - Phone
- (320) 532-4163
- NPI assigned
- Mar 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2575 | MN | |
| Clinical Social Worker | 1041C0700X | 17509 | MN | Primary |
Addresses
Primary practice location
18562 Minobimaadizi Loop
Onamia, MN 56359-3001
Mailing address
18562 Minobimaadizi Loop
Onamia, MN 56359-3001
Phone (320) 532-4163
Other names 1
- Crystal Houle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17509 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1043551310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18562 MINOBIMAADIZI LOOP",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563593001",
"telephone_number": "320-532-4163",
"fax_number": "320-532-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18562 MINOBIMAADIZI LOOP",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563593001",
"telephone_number": "320-532-4163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WECKERT",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2022-04-29",
"certification_date": "2022-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "2575",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "17509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "HOULE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Onamia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.