Krystal L Witthaus, LCSW
Individual provider Active NPI Clinical Social Worker · Hermann, MO
NPI 1851528087 · NPPES record last updated May 1, 2025
Key facts
- NPI
- 1851528087
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2008028021 (MO)
- Practice address
- 123 Bavarian Hills PLZ
Hermann, MO 65041-1613 - Phone
- (573) 486-2118
- Fax
- (573) 486-3533
- NPI assigned
- Jun 15, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506001317 | MO | Practitioner - Clinical Social Worker | 0446690648 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008028021 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hermann Area Hospital District | Current |
Accepting new patients | |
| Hermann Area Hospital District | Current |
Accepting new patients | |
| Hermann Area Hospital District | Past | Accepting new patients |
Locations
123 Bavarian Hills Plz
Hermann, MO 65041
Phone (573) 486-2118
509 W 18th St
Hermann, MO 65041
Phone (573) 486-2045
504 N Sturgeon St
Montgomery City, MO 63361
Phone (573) 564-2990
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2008028021 | MO | Yes |
Addresses
Primary practice location
123 Bavarian Hills PLZ
Hermann, MO 65041-1613
Mailing address
PO Box 19
Hermann, MO 65041-0019
Phone (573) 486-1193
Other providers in Hermann, MO
- Victorian Manor of Hermann Inc
- Adelyn Lee Wagner
- Kenneth R Wehrenberg
- Stephanie Williams
- Tracy Lynn Williams
All providers in Hermann, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.