Active NPI
Kerrie Marie Mazeika, MSW, LCSW
- Clinical Social Worker
- West Bend, WI
National Provider Identifier
1457609570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 333 E Washington St
West Bend, WI 53095-2585 - Phone
- (262) 335-4600
- NPI assigned
- Aug 21, 2012
- Last updated
- Nov 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8025-123 | WI | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
333 E Washington St
West Bend, WI 53095-2585
Mailing address
333 E Washington St Ste 2100
West Bend, WI 53095-2503
Phone (262) 335-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8025-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind, P.a. | Clinical | Current | Accepting new patients |
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
1433 N Water St
Ste 400
Milwaukee, WI 53202
Phone (262) 273-4886
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1457609570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E WASHINGTON ST STE 2100",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530952503",
"telephone_number": "262-335-4600",
"fax_number": "262-970-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E WASHINGTON ST",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530952585",
"telephone_number": "262-335-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZEIKA",
"first_name": "KERRIE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-21",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "8025-123",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.