Carissa Sietsema

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

118 Joseph Ave
Williamson, WV 25661-3306

Phone

(304) 859-8157

NPI assigned

Aug 6, 2019

Sex

Female

Sole proprietor

Yes

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.

• Ever Blooming Therapy Services LLC

  • Clinical Social Worker
  • Williamson, WV
  • NPI 1225735749
  Medicare reassignment NPD Authorized official CLINICAL · WV
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD CLINICAL · DC · KY
• Coalfield Family Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gay, WV
  • NPI 1508540303
  NPD
• Coalfield Family Services, PLLC

  • Clinical Social Worker
  • Fort Gay, WV
  • NPI 1811353154
  NPD CLINICAL

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2024.

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1689229759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2274",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 JOSEPH AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613306",
            "telephone_number": "304-859-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIETSEMA",
        "first_name": "CARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "SW071915161",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csietsema@coalfieldfamilyservices.com",
            "affiliation": "Y",
            "affiliationName": "Coalfield Family Services, PLLC",
            "address_1": "20824 Route 52",
            "city": "Fort Gay",
            "state": "WV",
            "country_code": "US",
            "postal_code": "255147074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diane Elain Shafer, M.D.
• Kimberly Sheppard, LSW
• Chynna Sherman
• Amanda Marie Shook, LPN
• Raj K Shrestha, MD
• Nathaniel Siggers
• Larry David Simpkins, RPH
• Abhai Singh, M.D.
• Margie Sizemore
• Alexis Paige Slone

• All providers in Williamson, WV
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.