Individual provider Active NPI

Kristy Lynn Berchulc, LMSW

  • Clinical Social Worker
  • Mebane, NC
National Provider Identifier
1720707755
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801087364 Issued in MI
Practice address
3050 Bluebird LN Apt 200
Mebane, NC 27302-9924
Phone
(586) 557-6953
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 6801087364 MI Primary

Addresses

Primary practice location

3050 Bluebird LN Apt 200
Mebane, NC 27302-9924

Mailing address

3050 Bluebird LN Apt 200
Mebane, NC 27302-9924
Phone (586) 557-6953

Other names 1

  • Kristy Lynn Stenzel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230405000529 MI Practitioner - Clinical Social Worker 0345615357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
International Therapy Solutions PLLCGroup PAC ID 9739463084, 14 clinicians

Practice addresses (Care Compare)

11480 E 13 Mile Rd
Warren, MI 48093-2566
Phone (586) 216-9253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801087364MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
International Therapy Solutions, PLLC Clinical CurrentSince Dec 28, 2022 Accepting new patients
International Therapy Solutions, PLLC Clinical PastSince Dec 28, 2022 Accepting new patients

Locations

11480 E 13 Mile Rd
Warren, MI 48093
Phone (586) 216-9253

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1720707755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 BLUEBIRD LN APT 200",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029924",
            "telephone_number": "586-557-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BLUEBIRD LN APT 200",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029924",
            "telephone_number": "586-557-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCHULC",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "STENZEL",
            "middle_name": "LYNN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mebane, NC

Sources for this page

Verify at the official NPI Registry.