Individual provider Active NPI

Kristine Krisko, LISW-S

  • Clinical Social Worker
  • Avon, OH
National Provider Identifier
1114220035
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0700054-SUPV Issued in OH
Practice address
1426 Center Rd
Avon, OH 44011-1214
Phone
(216) 468-5000
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0700054-SUPV OH Primary

Addresses

Primary practice location

1426 Center Rd
Avon, OH 44011-1214

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other practice location 1

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone (216) 320-8610

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151105000050 OH Practitioner - Clinical Social Worker 4284944182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

530 S Main St
Lima, OH 45804-1240
Phone (419) 222-1168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0700054-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Feb 1, 2019 Accepting new patients
The Metrohealth System CurrentSince Feb 1, 2019 Accepting new patients
Family Resource Center of Northwest Ohio Inc CurrentSince Nov 10, 2022 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

4269 Pearl Rd
Cleveland, OH 44109
Phone (216) 431-4131

3950 Chester Ave
Cleveland, OH 44114
Phone (216) 431-4131

530 S Main St
Lima, OH 45804
Phone (419) 222-1168

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1114220035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 CENTER RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111214",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22001 Fairmount Blvd",
            "address_purpose": "LOCATION",
            "city": "Shaker Heights",
            "state": "OH",
            "postal_code": "441184819",
            "country_code": "US",
            "telephone_number": "216-320-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISKO",
        "first_name": "KRISTINE",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0700054-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

Verify at the official NPI Registry.