Kristen Macneill Kern, LCSW

Individual provider Active NPI Clinical Social Worker · Ruckersville, VA

NPI 1245970425 · NPPES record last updated Feb 29, 2024

Key facts

NPI
1245970425
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904010090 (VA)
Practice address
8767 Seminole TRL Ste 101
Ruckersville, VA 22968-3494
Phone
(434) 990-1744
Fax
(434) 939-9401
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Life Works Professional Counseling, PLLC (7 clinicians)

Practice addresses (Care Compare)

8767 Seminole TRL
Suite 101
Ruckersville, VA 22968-3494
Phone (434) 990-1744

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220411000392 VA Practitioner - Clinical Social Worker 6305232802 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0904010090VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Works Professional Counseling, PLLC Mental Health Current
since Aug 1, 2022
Accepting new patients

Locations

8767 Seminole Trl
Ste 101
Ruckersville, VA 22968
Phone (434) 985-6909

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X
Clinical Social Worker 1041C0700X 0904010090 VA Yes

Addresses

Primary practice location

8767 Seminole TRL Ste 101
Ruckersville, VA 22968-3494

Mailing address

2490 Spring Brook Dr
Charlottesville, VA 22901-8996

Other providers in Ruckersville, VA

All providers in Ruckersville, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.