Kristin Michelle Krivickas, LCSW, CRADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015278 Issued in IL

Practice address

2215 14TH St
North Chicago, IL 60064-1618

Phone

(847) 984-5231

NPI assigned

Nov 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kristin.krivickas.1@15349.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14137/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eden Health Medical of Il LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1083297469
  NPD (past)

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1073814067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 STEVENS CT",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303532",
            "telephone_number": "847-691-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 14TH ST",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600641618",
            "telephone_number": "847-984-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIVICKAS",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CRADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015278",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Kozak, PA, RD
• Gustav R Kozina, D.D.S.
• Zachary Krall, CRNA
• Michael John Kremer, CRNA
• Emma Krick
• Marko Krneta
• Aravind Reddy Kuchkuntla
• Ewa Kuczala, RRT
• Manouj Kumar
• Connor Alexander Kuremsky, PA-C

• Clinical Social Worker in North Chicago, IL
• Providers in North Chicago, 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 3, 2015; 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.