Krystal L Gesicki, LISW, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600727-SUPV Issued in OH

Practice address

24500 Center Ridge Rd Ste 120
Westlake, OH 44145-5602

Phone

(330) 946-6925

Fax

(888) 868-7178

NPI assigned

Feb 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cle Counseling LLC

  • Counselor
  • Westlake, OH
  • NPI 1568948107

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1285094755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 120",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455602",
            "telephone_number": "330-946-6925",
            "fax_number": "888-868-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 120",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455602",
            "telephone_number": "330-946-6925",
            "fax_number": "888-868-7178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Northland Dr Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442563440",
            "country_code": "US",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2115 W Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lorain",
            "state": "OH",
            "postal_code": "440531138",
            "country_code": "US",
            "telephone_number": "440-989-4987",
            "fax_number": "440-282-4779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GESICKI",
        "first_name": "KRYSTAL",
        "middle_name": "L",
        "credential": "LISW, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "S1200918",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161416",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600727-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192132",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "I.1600727-SUPV",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LICDC.161416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Parker Gerace, MD
• Maria Christina Gerace, PA-C
• Michael Gercevich, DO
• Geriatric Physician Assistants LLC
• Marla Gerrek, RN,CNP
• Blen Getahun
• Marcos Ghali, PH.D., LPCC-S
• Khatren Ghanem, RN
• Yassin Ismat Ghanem, APRN, PMHNP
• Deborah M Ghazoul, MD

• Clinical Social Worker in Westlake, OH
• Providers in Westlake, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.