Kristin Tiedeken Wood, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016740 Issued in PA

Practice address

2 Logan SQ Ste 300
Philadelphia, PA 19103-2733

Phone

(484) 318-9151

NPI assigned

Feb 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1154869089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LOGAN SQ STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032733",
            "telephone_number": "484-318-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LOGAN SQ STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032733",
            "telephone_number": "484-318-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KRISTIN",
        "middle_name": "TIEDEKEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-12",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.thephillytherapistkristin@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Logan Sq Ste 300",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191032733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanne N Wood, MD
• Jonathan Harold Wood, V.M.D
• Joyce Wood, NP
• Kamillah Wood, M.D.
• Kanifah Monyae Wood, LSW
• Marcie J Wood, LMFT
• Pamela Lee Wood
• Phoenix Wood, LCSW
• Robert Wood, D.M.D.
• Sarah M Wood, M.D.

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.