Active NPI
Kaylyn Elizabeth Weller, LCSW-A
- Clinical Social Worker
- Wilmington, NC
National Provider Identifier
1194247692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P011688
- Practice address
- 1817 Sir Tyler Dr Apt 200
Wilmington, NC 28405-8542 - Phone
- (317) 650-6538
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P011688 | NC | Primary |
Addresses
Primary practice location
1817 Sir Tyler Dr Apt 200
Wilmington, NC 28405-8542
Mailing address
1817 Sir Tyler Dr Apt 200
Wilmington, NC 28405-8542
Phone (317) 650-6538
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
| License | State | Type | Specialty |
|---|---|---|---|
| P011688 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1194247692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1817 SIR TYLER DR APT 200",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284058542",
"telephone_number": "317-650-6538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1817 SIR TYLER DR APT 200",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284058542",
"telephone_number": "317-650-6538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "KAYLYN",
"middle_name": "ELIZABETH",
"credential": "LCSW-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P011688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
- Well Care Home Health of New Hanover, Inc.
- Well Care Home Health of the Midlands, Inc
- Well Care Home Health, Inc
- Well Within Chiropractic PLLC
- Elena Marie Buff Wellen, PHARMD
- Glenna Janette Wellman, PH.D.
- Wellness Through Balance Healing Arts, PLLC
- Wellness Without Walls
- Wellness Without Walls
- Edmund M Wellons, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.