Active NPI
Amy Kristine Konsewicz
- Social Worker
- Crystal City, MO
National Provider Identifier
1801281746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2013017694
- Practice address
- 107 Mississippi Ave
Crystal City, MO 63019-1633 - Phone
- (314) 435-6848
- NPI assigned
- Mar 30, 2015
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 2013017694 | MO | Primary |
Addresses
Primary practice location
107 Mississippi Ave
Crystal City, MO 63019-1633
Mailing address
4723 Alma Ave
Saint Louis, MO 63116-1101
Phone (217) 836-9787
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 |
|---|---|---|---|
| 2013017694 | MO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427673600000",
"number": "1801281746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4723 ALMA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631161101",
"telephone_number": "217-836-9787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 MISSISSIPPI AVE",
"city": "CRYSTAL CITY",
"state": "MO",
"postal_code": "630191633",
"telephone_number": "314-435-6848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONSEWICZ",
"first_name": "AMY",
"middle_name": "KRISTINE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-30",
"last_updated": "2015-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2013017694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.