Individual provider Active NPI

Erika Jean Kristensen, MSW, LCSW

  • Clinical Social Worker
  • Fernandina Beach, FL
National Provider Identifier
1124960612
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25988 Issued in FL
Practice address
1405 Park Ave Ste 201
Fernandina Beach, FL 32034-1951
Phone
(904) 895-4780
NPI assigned
Apr 6, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 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 25988 FL Primary

Addresses

Primary practice location

1405 Park Ave Ste 201
Fernandina Beach, FL 32034-1951

Mailing address

1405 Park Ave Ste 201
Fernandina Beach, FL 32034-1951

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

LicenseStateTypeSpecialty
25988FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1124960612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 PARK AVE STE 201",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 PARK AVE STE 201",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341951",
            "telephone_number": "904-895-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTENSEN",
        "first_name": "ERIKA",
        "middle_name": "JEAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "25988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.