Active NPI
Suzanne Wierenga-Keller, LISW
- Clinical Social Worker
- Clinton, IA
National Provider Identifier
1720028665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 04256
- Practice address
- 638 S Bluff Blvd
Clinton, IA 52732-4742 - Phone
- (563) 243-5633
- Fax
- (563) 243-9567
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 04256 | IA | Primary |
Addresses
Primary practice location
638 S Bluff Blvd
Clinton, IA 52732-4742
Mailing address
638 S Bluff Blvd
Clinton, IA 52732-4742
Phone (563) 243-5633
Other names 1
- Suzanne Wierenga-Keller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04256 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1720028665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "638 S BLUFF BLVD",
"city": "CLINTON",
"state": "IA",
"postal_code": "527324742",
"telephone_number": "563-243-5633",
"fax_number": "563-243-9567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "638 S BLUFF BLVD",
"city": "CLINTON",
"state": "IA",
"postal_code": "527324742",
"telephone_number": "563-243-5633",
"fax_number": "563-243-9567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIERENGA-KELLER",
"first_name": "SUZANNE",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "04256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUZANNE",
"last_name": "WIERENGA-KELLER",
"credential": "LISW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.