Krista Weckerly, M.S.W., LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I1502351 Issued in OH

Practice address

275 Martinel Dr
Kent, OH 44240-4380

Phone

(330) 673-6446

Fax

(330) 673-6443

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Krista Brawley Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  OH

  Medicare reassignment Care Compare group NPD
• Compass Family and Community Services

  • Community/Behavioral Health Agency
  • Warren, OH
  • NPI 1083054506
  NPD (past)
• The Bair Foundation

  • Developmental Disabilities Clinic/Center
  • Kent, OH
  • NPI 1922066224
  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1083033823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MARTINEL DR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404380",
            "telephone_number": "330-673-6446",
            "fax_number": "330-673-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MARTINEL DR",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404380",
            "telephone_number": "330-673-6446",
            "fax_number": "330-673-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECKERLY",
        "first_name": "KRISTA",
        "credential": "M.S.W., LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1201192",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1502351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "BRAWLEY",
            "credential": "M.S.W., LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Isabella Maureen Watson
• Kayleigh Watson
• Mellisa Watson
• Michael Patton Weatherford, LPC, NCC
• Ryan Weber
• Vondakae Weekly, LPN
• Marie Weese, QMHS
• Charity Weidow
• Rachel Weigel
• Pamela S Weis, PT

• Clinical Social Worker in Kent, OH
• Providers in Kent, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.