Kristin April Mervich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-17561 Issued in AZ

Practice address

3509 E Shea Blvd Ste 102
Phoenix, AZ 85028-3337

Phone

(872) 333-9282

Fax

(480) 581-7474

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kristin April Kohn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Outsmarting Anxiety & Ocd, LLC

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1588332241
  NPD Authorized official
• Adrienne Ahlquist, LCSW

  • Community/Behavioral Health Agency
  • Schaumburg, IL
  • NPI 1528504610
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1285181750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 E SHEA BLVD STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283337",
            "telephone_number": "872-333-9282",
            "fax_number": "480-581-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 E SHEA BLVD STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283337",
            "telephone_number": "872-333-9282",
            "fax_number": "480-581-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVICH",
        "first_name": "KRISTIN",
        "middle_name": "APRIL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020236",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-17561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KOHN",
            "middle_name": "APRIL",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Merry, LPC
• Callie Jo Mersbergen
• Amanda Mertel, PSY.D.
• Sara Mertel, PH.D., BCBA
• Camber Mertz, MD
• Adrienne Meryl, LCSW
• Barbara J Merz, M.D.
• Mesa Dental Arizona LLC
• Mesa Neighborhood Pharmacy LLC
• Mesa Neighborhood Pharmacy LLC

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.