Individual provider Active NPI

Krystin Mutchler

  • Clinical Social Worker
  • Atlantic Highlands, NJ
National Provider Identifier
1629512207
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05697600 Issued in NJ
Practice address
986 Leonardville Rd
Atlantic Highlands, NJ 07716-2713
Phone
(866) 832-6260
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 44SC05697600 NJ Primary

Addresses

Primary practice location

986 Leonardville Rd
Atlantic Highlands, NJ 07716-2713

Mailing address

986 Leonardville Rd
Atlantic Highlands, NJ 07716-2713
Phone (866) 832-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220621002842 NJ Practitioner - Clinical Social Worker 3173902111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Best Practices BhomGroup PAC ID 3072876994, 21 clinicians

Practice addresses (Care Compare)

81 Crooked Stick Rd
Jackson, NJ 08527-4032
Phone (609) 916-6402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05697600NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seaglass Counseling & Wellness Center, LLC Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1629512207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 LEONARDVILLE RD",
            "city": "ATLANTIC HIGHLANDS",
            "state": "NJ",
            "postal_code": "077162713",
            "telephone_number": "866-832-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 LEONARDVILLE RD",
            "city": "ATLANTIC HIGHLANDS",
            "state": "NJ",
            "postal_code": "077162713",
            "telephone_number": "866-832-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCHLER",
        "first_name": "KRYSTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05697600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic Highlands, NJ

Sources for this page

Verify at the official NPI Registry.