Individual provider Active NPI

Kerrie Marie Mazeika, MSW, LCSW

  • Clinical Social Worker
  • West Bend, WI
National Provider Identifier
1457609570
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
333 E Washington St
West Bend, WI 53095-2585
Phone
(262) 335-4600
NPI assigned
Aug 21, 2012
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211111000626 WI Practitioner - Clinical Social Worker 5890184907 Reassigns benefits to 1 organization
I20260316004025 PA Practitioner - Clinical Social Worker 5890184907 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
8025-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind, P.a. Clinical CurrentSince Feb 17, 2026 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 4, 2026 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

Verify at the official NPI Registry.