Kelli Lynn Wiethan, LCSW LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2008033440 Issued in MO

Practice address

751 E 63Rd St Ste 120C
Kansas City, MO 64110-3358

Phone

(816) 642-8634

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1437249265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E 63RD ST STE 120C",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103358",
            "telephone_number": "816-642-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E 63RD ST STE 120C",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103358",
            "telephone_number": "816-642-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETHAN",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "credential": "LCSW  LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076047",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3848",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2008033440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Jeffery Wieman, MD
• Sadie Jane Wiens, MEDICAL STUDENT (DO)
• Mary Patricia Wier, M.S.,CCC-SLP
• Andrea Bennett Wieser, PA-C
• Sean Alan Wiest, PMHNP
• Phyllis L Wiggins-Horne
• Abby E Wiggins, LCSW
• Gay Lynn Wiggs, RN, MSN
• Rose Leigh Wigodner, LCSW
• Wihy Ai, Inc.

• Clinical Social Worker in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.