Individual provider Active NPI

John Allen Kreitzer, MSW, LICSW

  • Clinical Social Worker
  • Wheeling, WV
National Provider Identifier
1437656964
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00943112 Issued in WV
Practice address
7 Edglawn Ave
Wheeling, WV 26003-6034
Phone
(304) 312-9792
NPI assigned
Apr 11, 2018
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X DP00943112 WV Primary

Addresses

Primary practice location

7 Edglawn Ave
Wheeling, WV 26003-6034

Mailing address

7 Edglawn Ave
Wheeling, WV 26003-6034
Phone (304) 242-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20180711003643 WV Practitioner - Clinical Social Worker 0941556583 Practice locations: Wheeling, WV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1025 Main St
Suite 708
Wheeling, WV 26003-2726
Phone (304) 312-9792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00943112WVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1437656964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 EDGLAWN AVE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036034",
            "telephone_number": "304-242-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 EDGLAWN AVE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036034",
            "telephone_number": "304-312-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZER",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00943112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.