Krysten Wall, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00941504 Issued in WV

Practice address

2002 Hogback Rd
Suite 15
Ann Arbor, MI 48105-9736

Phone

(734) 395-3433

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Monroe County Health Center Board of Trustees

  • Federally Qualified Health Center (FQHC)
  • New Castle, VA
  • NPI 1851585046
  NPD (past)
• Pyramid Counseling Limited Liability Company

  • Mental Health Counselor
  • Beckley, WV
  • NPI 1962546622
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1699863944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 HOGBACK RD",
            "address_2": "SUITE 15",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059736",
            "telephone_number": "734-395-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HOGBACK RD",
            "address_2": "SUITE 15",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059736",
            "telephone_number": "734-395-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KRYSTEN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00941504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "001733839",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "290040",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002567",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/CS",
            "identifier": "290040",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "481428",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7379889",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly J Walkovich, M.D.
• Elizabeth H Walkowiak, NP
• Heather Susan Walkowiak, NP
• Angela Marie Wall, LMSW
• Erin Wall
• Sarah Catherine Wall, MD
• James Allen Walla, RN
• Beth Ilene Wallace, MD
• Julia Wallace, MSW
• Leanne Michelle Wallace, RDH

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.