Kristina Kaye Wiersema, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801093573 Issued in MI

Practice address

1200 W Eleventh St Ste 218
Traverse City, MI 49684-3289

Phone

(231) 714-0292

Fax

(231) 714-0292

NPI assigned

Nov 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristy Wiersema Professional name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Authentic Life Counseling and Wellness, PLLC

  • Social Worker
  • Traverse City, MI
  • NPI 1518404128
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1346517513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13554 S HIGH POINT DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845534",
            "telephone_number": "231-714-0292",
            "fax_number": "231-714-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W ELEVENTH ST STE 218",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843289",
            "telephone_number": "231-714-0292",
            "fax_number": "231-714-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSEMA",
        "first_name": "KRISTINA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "WIERSEMA",
            "credential": "LMSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Whole Health Regenerative Medicine, PC
• Gregg B Wickstrom, M.D.
• Bridgett Widrig
• Jessica Wiemerslage
• Brent M Wiersema, D.O.
• Rebecca Louise Wiggins, NP
• Douglas Wigton, DO
• Thomas J. Wigton, CRNA
• Svea Perai Kayann Wikstrand, PA-C
• David J Wilcox, DO

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.